INCREASED LIPOPROTEIN (A) AND ITS RELATIONSHIPS WITH OTHER PARAMETERSOF LIPOPROTEIN METABOLISM IN CHRONIC-RENAL-FAILURE TREATED BY HEMODIALYSIS

Background. Studies have shown that patients with chronic renal failur e have a high frequency of cardiocascular atheromatous disease. Method s. We examined serum lipoprotein (a) [Lp(a)], very-low density lipopro tein cholesterol (VLDL-C), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), apolipoprotein Al ( ape Al) and B (ape B), triglyceride (TG) and total cholesterol (TC) le vels as possible risk factors for atherosclerosis in 4-5 patients with chronic renal failure (CRE) treated by hemodialysis (HD) and in 15 CR F patients who were not on HD. A control group of 20 healthy subjects was also studied. Results. The proportion of smokers and body mass ind exes were similar between the groups. In both patient groups, higher T G, TC and Lp(a) and lower apo Al and HDL-C levels in serum were found than in those of controls. Serum apo B and LDL-C were similar in the p atients treated by HD and the controls. Serum VLDL-C and LDL-C were si milar in the CRF patients who were not on HD and the controls. The hig hest ratios of apo B/apo Al and LDL-C/HDL-C were found in HD patients. The highest ratio of TC/HDL-C was found in the other patient group. W e found significant correlations between Lp(a) and other parameters of lipoprotein metabolism in CRF patients, both those who were and those who were not on HD. Conclusions. Our results indicate that CRF patien ts who both were and were not on HD show atherogenic changes in the li poprotein pattern, and that the increase in Lp(a) during the CRF phase is basically related to the loss of renal function and may also depen d on the resultant alterations which are produced in other lipoprotein variables.