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Lipoprotein‐associated phospholipase A2 predicts lower limb ischemia in hemodialysis subjects
Author(s) -
De Mauri Andreana,
Vidali Matteo,
Chiarinotti Doriana,
Dianzani Umberto,
Rolla Roberta
Publication year - 2020
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.13465
Subject(s) - medicine , ischemia , diabetes mellitus , population , lipoprotein(a) , hemodialysis , peripheral , lipoprotein associated phospholipase a2 , arterial disease , lipoprotein , multivariate analysis , critical limb ischemia , vascular disease , cholesterol , gastroenterology , cardiology , apolipoprotein b , endocrinology , environmental health
Hemodialyzed patients (HD) have high prevalence of peripheral arterial disease. In the general population, lipoprotein‐associated phospholipase A2 (Lp‐PLA 2 ) is associated with peripheral arterial disease but no data are available for renal subjects. The aim of this study was to evaluate the relationship between Lp‐PLA 2 and lower limb ischemia among dialyzed patients. One hundred and two dialyzed subjects, with median (IQR) age of 71 (59‐78) years, enrolled in June 2013 and followed until June 2018, were investigated for Lp‐PLA 2 activity and the occurrence of peripheral arterial disease and lower limb ischemia. The median (IQR) levels of Lp‐PLA 2 were 184 nmol/min/mL (156.5‐214.5). The 43 HD patients with abnormal Lp‐PLA 2 activity (>194 nmol/min/mL) had higher levels of total and LDL‐cholesterol, ApoB/A1 ratio, and higher occurrence of lower limb ischemia during the follow up (44% vs 17%, P = .003). In multivariate analysis, Lp‐PLA 2 activity ( P = .018) and diabetes ( P < .001) were independently associated with time to lower limb ischemia, and when the presence of previous PAD was added to the multivariate model, only presence of previous PAD ( P < .001) and Lp‐PLA 2 ( P = .003) remained associated. Lp‐PLA 2 is an independent predictor of lower limb ischemia in dialyzed patients.