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Lipids and lipoprotein(a) as risk factors for vascular disease in patients on renal replacement therapy.

Abstract
A large cohort of patients on renal replacement therapy were screened for the presence of symptomatic arterial disease affecting the coronary, cerebral or peripheral circulations. Ninety-two of 325 patients were found to have vascular disease. Those with vascular disease had significantly higher median lipoprotein(a) [Lp(a)] levels than those without (38.4 vs 14.2 mg/dl, P < 0.001), with a preponderance of Lp(a) levels greater than 30 mg/dl (58% vs 25% P < 0.001). Apolipoprotein(a) [apo(a)] isoform distribution was similar between the groups, but those with vascular disease had higher Lp(a) levels in the S2, S3/S4 and S4 isoform types. Comparison of 76 matched pairs of patients confirmed elevated Lp(a) levels in those with vascular disease. These patients also had significantly higher total cholesterol (6.66 vs 6.02 mmol/l) and low-density lipoprotein cholesterol (4.49 vs 3.86 mmol/l). Only Lp(a) was independently associated with vascular disease (P = 0.02). Elevated Lp(a) levels are significantly associated with the presence of vascular disease in patients on renal replacement therapy and may constitute another risk factor for the development of such disease in these patients.
AuthorsA T Webb, D A Reaveley, M O'Donnell, B O'Connor, M Seed, E A Brown
JournalNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 10 Issue 3 Pg. 354-7 ( 1995) ISSN: 0931-0509 [Print] England
PMID7792030 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Apolipoproteins A
  • Lipids
  • Lipoprotein(a)
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Apolipoproteins A (blood)
  • Cohort Studies
  • Female
  • Humans
  • Lipids (blood)
  • Lipoprotein(a) (blood)
  • Male
  • Middle Aged
  • Renal Insufficiency (blood, therapy)
  • Renal Replacement Therapy
  • Risk Factors
  • Vascular Diseases (blood)

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