LIPOPROTEIN(A) AND TREATMENT OF CHRONIC RENAL-DISEASE

Objectives. To compare lipoprotein(a) [Lp(a)] and albumin concentratio ns in patients with chronic renal disease receiving different forms of treatment and to determine, if any, the relationship between these va riables. Design. A prospective cross-sectional, case-controlled study. Setting. A tertiary referral nephrology and dialysis unit. Subjects. Forty-four consecutive non-diabetic patients with chronic renal failur e treated by renal transplantation (n = 18), haemodialysis (n = 18), c ontinuous ambulatory peritoneal dialysis (CAPD; n= 8), and 30 healthy controls from subjects drawn from University personnel were studied. I nterventions. Fasting morning venous blood was analysed for Lp(a), alb umin, total cholesterol and glucose concentrations. Main outcome measu res. Comparison of plasma levels of these variables between the sub-gr oups. Results. Concentrations (median: 95% CI) of Lp(a) were significa ntly (P < 0.05) higher (38.4 mg dl(-1); range 15.4-72.0) and of albumi n lower (31.6 g l(-1); range 28-35.2) in the CAPD group compared with both control subjects and other groups of chronic renal disease patien ts. Conclusions. The elevated Lp(a) concentrations seen only in associ ation with reduced albumin concentrations in CAPD patients suggest a r egulatory role for albumin with albumin losses stimulating production of Lp(a).