Levels of Plasma Lipoprotein(a) in Continuous Ambulatory Peritoneal Dialysis Are Not Related to Peritoneal Losses of Albumin

Dr. Jesús Montenegro, Servicio de Nefrología, Hospital de Galdácano, E-48960 Galdácano. Vizcaya (Spain), Tel. (4) 4369000, Fax (4) 4566268 Dear Sir, Lipoprotein(a), Lp(a), is a risk factor of coronary heart disease, independent of other factors [1]. Plasma levels of Lp(a) have been reported to be found more frequently and markedly increased in continuous ambulatory peritoneal dialysis (CAPD) patients than in normal people [2]. The mechanism for this elevation is poorly understood. However, two features specific to CAPD, the peritoneal absorption of glucose and protein losses in the dialysate, have been suggested as causes of an increased synthesis or, perhaps, decreased catabolism of Lp(a) [3]. Recently in Nephron, Heimbürger et al. [4] reported that the elevation of Lp(a) in CAPD patients was related to peritoneal losses of albumin (Alb.) and to the peritoneal transport of proteins and glucose. The aim of this letter is to show the different results we obtained in a similar study. A total of 59 adult stable CAPD patients (42% women) with a mean age of 57 ± 15 years and a mean weight of 68 ± 10 kg were enrolled in a cross-sectional study. The duration of CAPD treatment was 28 ± 15 months on average. None of the patients were treated with any lipidlowering drugs. The cause of renal failure was diabetic ne-phropathy in 5 patients and anuria in another 18 patients. The prescribed daily dialysate volume was 8 liters in the majority of the patients. After an overnight fast, blood samples for determination of plasma Lp(a), serum Alb., cholesterol, triglycerides, high-density lipo-protein cholesterol, low-density lipoprotein cholesterol, creatinine (Cr), urea and ß2Table 1. Results of all patients, means and standard deviations