LP(A) LEVELS - EFFECTS OF PROGRESSIVE CHRONIC-RENAL-FAILURE AND DIETARY MANIPULATION

Patients with chronic renal failure (CRF) have an increased risk of ca rdiovascular disease (CVD), Elevated lipoprotein(a) (LP(a)) levels hav e been shown to be an important risk factor for CVD, This study examin ed Lp(a) changes during the progression of renal disease in patients f ollowing different dietary regimens, Fifty-seven patients with CRF of different etiology and degree (mean age 58 +/- 10 yrs) were divided in to four groups according to their serum creatinine (sCr) levels, The f irst group had sCr 1.5-3; the second 3-6; the third >6, all on a conve ntional low-protein diet (CLPD), and the fourth had sCr >6 on a supple mented vegetarian diet (SVD), Lp(a), apoproteins AI, B, E, CII, CIII, CII/CIII, Apo A/Apo B ratios and the lipid pattern (total cholesterol (TC) and its fractions LDL, HDL, HDL3 and triglycerides) were investig ated, Patients with diabetes, proteinuria >1.5g/24h, hepatic disease o r taking contraceptives or lipid lowering drugs were excluded, Results were compared with a reference group (N=12) with sCcr<1. Lp(a) concen trations increased with the progression of renal failure, and a signif icant correlation was observed with sCr, Despite the elevated sCr leve ls, patients on the SVD had an almost normal Lp(a) concentration, Only 15% of the reference group had Lp(a) levels >30 mg/dl, compared to 33 %, 50% and 78% of the 1st, 2nd and 3rd groups and 38% of the 4th group , No relationship was found between Lp(a), lipids or apoproteins, Our results indicate that renal function influences Lp(a) levels and sugge st a SVD helps to lower them. This might be ascribed to some antioxida nt factors in the SVD.