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Lipoprotein(a) in nephrotic syndrome
P Stenvinkel1, L Berglund, O Heimbürger
1Department of Renal Medicine, Huddinge University Hospital, Karolinska Institute, Sweden.
Kidney International
|November 1, 1993
Summary
Elevated Lipoprotein(a) [LP(a)] levels are common in nephrotic syndrome (NS) and correlate with cholesterol and edema. These LP(a) levels decrease upon remission, suggesting a link to NS pathophysiology.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Clinical Biochemistry
Background:
- Lipoprotein(a) [LP(a)] is an independent cardiovascular disease risk factor and potential thrombotic agent.
- Gross proteinuria is associated with increased plasma LP(a), but the underlying mechanism remains unclear.
- Nephrotic syndrome (NS) is characterized by heavy proteinuria and edema, with potential links to cardiovascular risk.
Purpose of the Study:
- To investigate plasma Lipoprotein(a) [LP(a)] levels in patients with nephrotic syndrome (NS).
- To explore the relationship between LP(a) levels and clinical parameters in NS.
- To assess changes in LP(a) levels following remission of NS.
Main Methods:
- Plasma LP(a) levels were measured in 31 NS patients, 24 IgA nephropathy patients, and 43 healthy controls.
- Correlations were analyzed between LP(a) and serum lipids, urinary protein, GFR, edema, ANP, and urinary sodium.
- LP(a) levels were re-evaluated in NS patients after achieving remission.
Main Results:
- LP(a) levels were significantly elevated in NS patients (median 49.0 mg/dl) compared to controls (7.0 mg/dl) and IgA nephropathy patients (9.7 mg/dl).
- In NS, LP(a) correlated positively with serum cholesterol and ANP, and negatively with plasma orosomucoid and urinary sodium excretion.
- LP(a) levels decreased markedly after NS remission and showed strong correlations with VLDL cholesterol and triglycerides.
Conclusions:
- Plasma LP(a) is significantly elevated in nephrotic syndrome, suggesting a role in the condition's pathophysiology.
- LP(a) levels in NS are linked to lipid profiles, particularly VLDL, and markers of fluid retention like ANP.
- The observed decrease in LP(a) upon remission supports its association with the active phase of NS.