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Correlation of Inflammation and Lipoprotein (a) with Hypercoagulability in Hemodialysis Patients
Valdete Topçiu-Shufta1, Valdete Haxhibeqiri1, Luljeta Begolli1
1Clinic of Medical Biochemistry, University Clinical Center, Prishtina, Republic of Kosova ; Faculty of Medicine, University of Prishtina, Republic of Kosova.
Insights
Hemodialysis patients exhibit elevated lipoprotein (a) [Lp(a)] and procoagulant markers, increasing their risk for cardiovascular disease. These findings highlight the link between inflammation and cardiovascular complications in this population.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Cardiovascular disease is a significant risk in hemodialysis patients.
- Inflammatory and procoagulant markers are implicated in this cardiovascular risk.
- Lipoprotein (a) [Lp(a)] is a key risk factor with inflammatory and procoagulant properties.
Purpose of the Study:
- To investigate the association between inflammatory markers, lipoprotein (a) [Lp(a)], and procoagulant markers in hemodialysis patients.
- To compare these markers in hemodialysis patients versus healthy controls.
- To explore the correlation between C-reactive protein (CRP) and other markers in patients with elevated CRP.
Main Methods:
- Measured CRP, Interleukin-6 (IL-6), Lp(a), fibrinogen, D-dimer, von Willebrand factor (vWF), and serum albumin in 78 hemodialysis patients and 40 controls.
- Stratified patients based on CRP levels (elevated vs. normal).
- Analyzed correlations between CRP, IL-6, Lp(a), fibrinogen, D-dimer, vWF, and serum albumin.
Main Results:
- Hemodialysis patients showed significantly higher levels of CRP, IL-6, Lp(a), fibrinogen, D-dimer, and vWF, and lower serum albumin compared to controls.
- Patients with elevated CRP exhibited significant differences in these markers compared to those with normal CRP.
- CRP and IL-6 strongly correlated with Lp(a), fibrinogen, D-dimer, vWF, and inversely with serum albumin in patients with elevated CRP.
Conclusions:
- Hemodialysis patients with elevated inflammatory markers have increased Lp(a) and procoagulant markers.
- These findings suggest a heightened risk for atherosclerotic cardiovascular disease in hemodialysis patients with increased inflammation.
- Lp(a) and procoagulant markers are important indicators of cardiovascular risk in hemodialysis patients.
Background:
Inflammatory and procoagulant markers are potential mediators for the cardiovascular risk in hemodialysis patients. Lipoprotein (a) [Lp(a)], is another important risk factor with inflammatory and procoagulant effects.
Materials And Methods:
In 78 hemodialysis patients and 40 controls, C-reactive protein (CRP), Interleukin-6 (IL-6), lipoprotein (a) [Lp (a)], fibrinogen, D-dimer, von Wilebrand factor (vWF) and serum albumin were determined.
Results:
CRP, IL-6, Lp(a), fibrinogen, D-dimer and vWF, were significantly higher, and serum albumin was significantly lower in patients compared to controls (24.40 mg/L vs. 6.39 mg/L, p<0.001; 1.92 pg/ml vs. 0.35 pg/ml, 28.05 mg/dL vs.16.25 mg/dL, p<0.001; 3.44 g/L vs. 2.55 g/L, p<0.01; 1.81 µgFEU /ml vs. 0.50 µgFEU /ml, p<0.01; 152.9 % vs. 85.6 %, p<0.001; 32.1 g/L vs. 40.50 g/L, p<0.001). The patients were divided into two groups: 40 patients with CRP levels over than 10 mg/L and 38 with CRP levels in normal range. These parameters showed significant differences between patients with elevated CRP and patients with normal CRP levels. CRP and IL-6 correlated positively with Lp(a), (r = 0.62, p < 0.001; r=0.54, p<0.001), fibrinogen, (r = 0.63, p < 0.001; r = 0.49, p<0.01) D dimer (r = 0.72, p<0.001; r = 0.55, p<0.01), vWF (r = 0.76, p<0.01; r = 0.63, p<0.001) and negatively with serum albumin (r = -0.80, p<0.01; r = -0.60, p<0.001), in patients with elevated CRP, but not in patients with normal CRP levels and controls.
Conclusion:
According to the results hemodialysis patients with increased inflammatory markers, have the elevated Lp(a) and procoagulant markers and the greater risk for atherosclerotic cardiovascular disease.
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