CORRELATION BETWEEN OXIDIZED LOW-DENSITY LIPOPROTEINS AND VON-WILLEBRAND-FACTOR IN CHRONIC-RENAL-FAILURE

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.