Lipoprotein abnormalities in chronic haemodialysis patients

Measurement of lipids, apolipoproteins A-I, A-II, B, C-III, Lp(a) and cholesterol, phospholipids, apo C-III in lipoprotein with and without apolipoprotein B was made in 49 patients (18 women and 31 men; mean age 50 +/- 15 years) undergoing maintenance haemodialysis for chronic renal failure. A group of 49 healthy people, matched for sex and age, acted as controls. In the haemodialysis group, special attention was placed upon the comparison of patients who had evident cardiovascular alterations (n = 17) with the residual group (n = 32). The concentration of apo C-III in apolipoprotein B containing lipoproteins was statistically higher in the patients with arterial disease than in the remaining subjects, whereas the ratio apo C-III from Lp no B/apo C-III from Lp B was decreased. Compared to controls, haemodialysis patients had significantly higher values of triglycerides, apolipoproteins C-III, Lp(a), and apolipoprotein C-III from apolipoprotein B-containing lipoproteins (LpB); in contrast, concentrations of phospholipids and cholesterol from lipoproteins without apolipoprotein B (Lp no B) and apolipoprotein A-II were significantly reduced in patients. Discriminant analysis indicated that the levels of apolipoprotein C-III and apolipoprotein C-III from LpB were the best indicators of deranged lipid transport in patients with chronic renal failure. Our data suggest that chronic haemodialysis patients tend to exhibit qualitative abnormalities of serum apolipoprotein-B triglyceride rich particles containing apolipoprotein C-III or (a).