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Apolipoprotein(a) phenotype-associated decrease in lipoprotein(a) plasma concentrations after renal transplantation

F Kronenberg1, P König, K Lhotta

  • 1Institute of Medical Biology and Human Genetics, Innsbruck, Austria.

Arteriosclerosis and Thrombosis : a Journal of Vascular Biology
|September 1, 1994
PubMed
Summary
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High lipoprotein(a) [Lp(a)] levels in end-stage renal disease (ESRD) patients are not genetic. Renal transplantation rapidly normalizes these elevated Lp(a) concentrations, indicating a disease-related cause.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Genetics

Background:

  • High lipoprotein(a) [Lp(a)] plasma concentrations are a significant independent risk factor for atherosclerosis.
  • In the general population, Lp(a) levels are primarily determined by genetic variations in the apolipoprotein(a) [apo(a)] gene locus.
  • Patients with end-stage renal disease (ESRD) exhibit elevated Lp(a) levels, which are not adequately explained by apo(a) size variation.

Purpose of the Study:

  • To investigate the origin of elevated Lp(a) plasma concentrations in ESRD patients.
  • To examine Lp(a) concentrations and apo(a) phenotypes in ESRD patients before and after renal transplantation.

Main Methods:

  • Prospective longitudinal study design.
  • Analysis of Lp(a) concentrations and apo(a) phenotypes in 154 ESRD patients.

Related Experiment Videos

  • Measurement of Lp(a) levels before and 3 weeks after renal transplantation.

    • Main Results:

    • A significant rapid normalization of Lp(a) levels was observed post-transplantation (average 25.9 to 17.9 mg/dL, P < .0001).
    • Only patients with high-molecular-weight apo(a) phenotypes showed a significant decrease in Lp(a) concentrations.
    • The findings suggest a nongenetic origin for elevated Lp(a) in ESRD patients, linked to the disease itself.

    Conclusions:

    • Elevated Lp(a) concentrations in ESRD patients are primarily caused by the disease, not genetic factors.
    • Renal transplantation leads to a significant reduction in Lp(a) levels in ESRD patients.
    • A phenotype-associated elevation of Lp(a) concentrations in ESRD is confirmed.