P. Holvoet et al., CORRELATION BETWEEN OXIDIZED LOW-DENSITY LIPOPROTEINS AND VON-WILLEBRAND-FACTOR IN CHRONIC-RENAL-FAILURE, Thrombosis and haemostasis, 76(5), 1996, pp. 663-669
An ELISA specific for a wide spectrum of oxidized apo B-100 in OxLDL w
as developed and applied to blood samples from 27 control subjects, 20
mild chronic renal failure (MCRF) patients, 21 severe chronic renal f
ailure patients on conservative treatment (SCRF) and 56 severe chronic
renal failure patients on maintenance hemodialysis (HEMO). Mean lever
s of OxLDL were 0.59 mg/dl in controls (95% CI, 0.52-0.66 mg/dl), and
were 2.7-fold (p <0.01), 3.1-fold (p <0.001) and 5.4-fold (p <0.001) h
igher in MCRF, SCRF and HEMO patients, respectively. Levels of von Wil
lebrand factor, a marker of endothelial injury, were 100 percent in co
ntrols (95% CI, 90-110 percent), and were 1.5-fold (p = NS), 1.6-fold
(p <0.01) and 2.1-fold (p <0.001) higher in MCRF, SCRF and HEMO patien
ts, respectively. Multiple regression analysis revealed that the exten
t of renal failure (F = 14; p = 0.0004) accounted for a significant fr
action of the Variation in OxLDL levels, also after exclusion of patie
nts with evidence of ischemic atherosclerotic disease (F = 21; p = 0.0
001). After adjustment for the extent of renal failure, hemodialysis (
F = 5.6; p = 0.021) and LDL cholesterol levels (F = 7.1, p = 0.0095) c
ontributed significantly to the variation in OxLDL levels. Whereas the
extent of renal failure contributed only marginally to the individual
variations in vWF levels (F = 4.1; p = 0.048), these levels correlate
d significantly with plasma levels of OxLDL (F = 26; p = 0.0001). In c
onclusion, atherogenic OxLDL increase progressively during the develop
ment of renal failure suggesting that the oxidation of LDL may be asso
ciated with endothelial injury and atherogenesis in these patients.