LIPOPROTEIN (A) LEVELS IN END-STAGE RENAL-FAILURE AND RENAL-TRANSPLANTATION

Some previous studies have documented an increase in lipoprotein (a) [ Lp(a)] levels in renal diseases. Here, we report data in subjects with end-stage renal failure treated with hemodialysis (HD) or with contin uous ambulatory peritoneal dialysis (CAPD) and in renal transplant rec ipients (RTR), compared with a group of normolipidemic controls (C). L p(a) levels were significantly increased in HD and CAPD patients in co mparison with C, while they were only slightly increased in RTR. Both HD and CAPD patients showed Lp(a) levels higher than in RTR, but no di fference was found between the subjects of the two dialysis procedures . The prevalence of Lp(a) levels > 25 mg/dl was significantly higher i n HD and CAPD patients, but not in RTR, in comparison with C. Moreover , Lp(a) levels did not change after HD. When patients were divided acc ording to their fasting lipid levels in normolipidemics and hyperlipop roteinemics, no difference was found for Lp(a) levels in any group. Me chanisms underlying the increase in Lp(a) levels in these patients are not known. It is possible to suggest an active role of the kidney in the Lp(a) metabolism or that uremic plasma contains some factors affec ting Lp(a) metabolism.