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[Lp(a) lipoprotein in patients on maintenance hemodialysis--a study from apo(a) isoform]
Insights
Patients on maintenance hemodialysis (HD) have higher lipoprotein(a) [Lp(a)] levels and distinct apo(a) isoform patterns compared to healthy individuals. These findings highlight potential cardiovascular risks associated with Lp(a) in dialysis patients.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Clinical Chemistry
Context:
- Lipid abnormalities are implicated in cardiovascular disorders among patients undergoing maintenance hemodialysis (HD).
- Hypertriglyceridemia and reduced HDL-cholesterol are common in HD patients.
- Lipoprotein(a) [Lp(a)] and apo(a) isoforms are gaining attention for their role in cardiovascular disease.
Purpose:
- To compare Lp(a) levels and apo(a) isoform frequencies in patients on maintenance hemodialysis versus normal subjects.
- To investigate potential associations between Lp(a), apo(a) isoforms, and cardiovascular risk in the HD population.
Summary:
- Hemodialysis patients exhibited significantly elevated Lp(a) levels compared to controls.
- HD patients showed a higher prevalence of the S2 apo(a) isoform and a lower prevalence of the S4 isoform.
- A high frequency of the S2/S3 double band apo(a) isoform was observed in HD patients, particularly those on long-term dialysis.
Impact:
- This study identifies elevated Lp(a) and specific apo(a) isoform distributions as potential biomarkers for cardiovascular risk in maintenance hemodialysis patients.
- Findings contribute to understanding the dyslipidemia associated with end-stage renal disease and its cardiovascular complications.
- Further research may explore therapeutic strategies targeting Lp(a) in this vulnerable patient group.
Abstract:
It has been suggested that lipid abnormalities may be involved in the development of cardiovascular disorders in patients on maintenance hemodialysis (HD). Hypertriglyceridemia commonly accompanies this condition and is associated with decreased concentrations of HDL-cholesterol. Recent clinical interest has been paid to the disturbances of Lp(a) and apo (a) isoform in relation to cardiovascular disorders. Although high concentrations of Lp(a) are associated with ischemic heart disease, we are unaware of the availability of such data concerning patients on maintenance hemodialysis. We therefore compared levels of Lp(a) and the frequency of occurrence of their isoforms in 310 patients (chronic glomerulonephritis, N = 221; diabetic nephropathy, N = 77; polycystic kidney disease, N = 12) on maintenance hemodialysis and in 212 normal subjects. The following results were obtained. (1) HD patients showed significantly elevated levels of Lp(a) compared to normal subjects. (2) Studies of apo (a) isoform showed that HD patients showed high frequency of S2 and low frequency of S4. (3) HD patients, especially long-term patients, showed high frequency of double band (S2/S3). (4) There were no significant differences in the levels of Lp(a) and in the frequency of apo(a) isoform among 3 different etiological studies.