Premium
Lipoprotein (a) in CRF: Effect of Maintenance Hemodialysis
Author(s) -
Kalra OP,
Khaira A,
Gambhir JK,
Agarwal S,
Bhargava SK
Publication year - 2003
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1046/j.1492-7535.2003.01243.x
Subject(s) - medicine , hemodialysis , lipoprotein(a) , uremia , lipoprotein , chronic renal failure , intima media thickness , coronary artery disease , cardiology , gastroenterology , endocrinology , carotid arteries , cholesterol
Coronary artery disease is a major cause of morbidity and mortality in patients with chronic renal failure (CRF). Besides the higher prevalence of traditional risk factors, several uremia‐related factors may play a role. Although lipoprotein (a)[Lp (a)] is largely determined by genetic factors, there is some evidence to suggest elevated levels of Lp (a) in patients with CRF. However, the effect of maintenance hemodialysis (MHD) on Lp (a) levels has not been studied. Objective: To evaluate the profile of serum Lp (a) and carotid intima‐media thickness (IMT) in patients with various grades of CRF and to study the effect of MHD on Lp (a) levels in patients with advanced CRF. Methods: The study group comprised of patients with mild to moderate CRF (n = 15) and advanced CRF (n = 15). Fifteen healthy controls were also enrolled. Serum Lp (a) level was measured and carotid doppler study was done in all cases. In patients with advanced CRF serum Lp (a) level was again measured after one month of MHD. Results: Serum Lp (a) showed a progressive rise with increase in severity of CRF. As against 20% controls, 60% of patients with mild‐moderate CRF and 73% of patients with advanced CRF had Lp (a) levels more than 30 mg/dl. In patients with advanced CRF, repeat Lp (a) levels after 4 weeks of MHD showed a decline by 23.6% with a range of 2.5%–50%(p < 0.001)(Figure) However there was no significant difference in the carotid IMT amongst the three groups. Conclusion: Patients with CRF have significant elevation of Lp (a) level. This lipid abnormality starts early during the course of CRF and shows progressive worsening with increase in severity of CRF. In patients with advanced CRF, MHD results in significant decline in Lp (a) levels.