Secondary Hyperparathyroidism, Decreased Hepatic Triglyceride Lipase, Elevated Intermediate Density Lipoprotein and Atherosclerosis in Hemodialysis Patients

Cardiovascular mortality is higher in dialysis patients than the nonuremic population. This has been taken to indicate that dialysis patients have accelerated atherosclerosis [1]. We have recently revealed that atherosclerosis in hemodialysis patients is advanced morphologically, showing a greater intima media thickness in the carotid and femoral arteries in dialysis patients than healthy control subjects by high-resolution B mode ultrasonography [2]. Lipoprotein abnormality is one of the major risk factors for atherosclerosis in the general population, and recent studies [3–6] reemphasize the importance of triglyceride-rich lipoproteins such as partially lipolyzed very low density lipoprotein (VLDL) and intermediate density lipoprotein (IDL). These lipoprotein classes are significantly elevated in patients with chronic renal failure [7–9].