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Response of angiopoietin-like proteins 3 and 4 to hemodialysis

Dana Mahmood1, Elena Makoveichuk, Solveig Nilsson

  • 11 Department of Public Health and Clinical Medicine Umeå University, Umeå - Sweden.

The International Journal of Artificial Organs
|March 18, 2014
PubMed

Insights

Angiopoietin-like proteins 3 and 4 (ANGPTL3/4) are elevated in chronic hemodialysis (cHD) patients. High-flux hemodialysis partially removed ANGPTL4, while citrate anticoagulation reduced ANGPTL4 levels.

Area of Science:

  • Nephrology
  • Endocrinology
  • Lipid Metabolism

Background:

  • Patients on chronic hemodialysis (cHD) exhibit reduced lipoprotein lipase (LPL) activity.
  • Angiopoietin-like proteins (ANGPTL) 3 and 4 are known LPL inhibitors.

Purpose of the Study:

  • To investigate plasma levels of ANGPTL3 and ANGPTL4 in cHD patients.
  • To evaluate the impact of cHD on ANGPTL levels.

Main Methods:

  • Cross-over study comparing citrate and tinzaparin anticoagulation in cHD patients (n=23) and controls (n=23).
  • Analysis of ANGPTL3, ANGPTL4, LPL, and triglycerides.
  • Samples analyzed during low-flux and high-flux hemodialysis (HD), and ultrafiltrate (UF).

Main Results:

  • ANGPTL3 and ANGPTL4 levels were significantly higher in cHD patients compared to controls.
  • ANGPTL4 levels increased during cHD and decreased after 180 minutes of HD.
  • High-flux HD partially removed ANGPTL4, detected in UF, while low-flux HD did not.
  • Citrate anticoagulation led to decreased ANGPTL4 levels, unlike tinzaparin which caused ANGPTL4 release.

Conclusions:

  • Elevated ANGPTL3 and ANGPTL4 are observed in cHD patients.
  • Tinzaparin anticoagulation during cHD releases ANGPTL4 from tissues.
  • High-flux filters partially clear ANGPTL4, and citrate reduces its levels.
Abstract

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