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Elevated lipoprotein (a) levels in primary nephrotic syndrome

C Faucher1, C Doucet, A Baumelou

  • 1Institut National de la Santé et de la Recherche Médicale Unité 321, Paris, France.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|December 1, 1993
PubMed
Summary

Plasma levels of lipoprotein (a) [Lp(a)] are significantly elevated in nephrotic syndrome patients. This finding suggests an increased risk for cardiovascular and thrombotic complications in this population.

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Area of Science:

  • Nephrology
  • Cardiology
  • Lipidology

Background:

  • Nephrotic syndrome is associated with elevated total cholesterol and hepatic synthesis of apo B-containing lipoproteins.
  • Lipoprotein (a) [Lp(a)], of hepatic origin, possesses atherogenic and thrombogenic activities.
  • Limited data exist on Lp(a) levels in nephrotic patients.

Purpose of the Study:

  • To measure plasma Lp(a) concentrations in patients with primary nephrotic syndrome.
  • To investigate the relationship between Lp(a) levels and clinical parameters in nephrotic syndrome.
  • To assess the impact of remission on Lp(a) levels.

Main Methods:

  • Plasma Lp(a) concentrations were measured in 11 nephrotic patients and controls.
  • Nephrotic patients had minimal-change disease, membranous glomerulopathy, or focal and segmental glomerulosclerosis.

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  • Correlations were assessed between Lp(a) and proteinuria, albuminemia, cholesterol, LDL-C, apo B100, plasminogen, and apo(a) isoform size.

    • Main Results:

    • Mean Lp(a) levels were markedly elevated in nephrotic patients (98 +/- 92 mg/dL) compared to controls (14 +/- 13 mg/dL).
    • No significant correlations were found between Lp(a) and proteinuria, albuminemia, total cholesterol, LDL-C, apo B100, plasminogen, or apo(a) isoform size.
    • Lp(a) levels decreased significantly (fourfold) in four patients after remission induced by corticosteroid treatment.

    Conclusions:

    • Plasma Lp(a) levels are significantly elevated in nephrotic syndrome.
    • Elevated Lp(a) in nephrotic syndrome may indicate an increased risk of cardiovascular and thrombotic complications.
    • Lp(a) levels may be responsive to treatment and remission of nephrotic syndrome.