SERUM LIPOPROTEIN-(A) LEVELS IN MAINTENANCE HEMODIALYSIS-PATIENTS

To further understand lipoprotein (a) [Lp(a)] and atherosclerosis, we measured serum Lp(a), lipoprotein, and apolipoprotein levels in 55 pat ients (males, 24-73 years old) on maintenance hemodialysis, and compar ed them with those of 82 controls (males, 21-81 years old). The serum Lp(a) levels in patients on maintenance hemodialysis were significantl y higher than those of the normal controls, while serum total choleste rol (TC), high-density lipoprotein-cholesterol, (HDL-C), HDL2-C, HDL3- C, apolipoprotein (apo) Al, apo All levels, and lecithin-cholesterol a cyltransferase (LCAT) activities were significantly (p < 0.05) reduced in the patient group. The frequency distribution of serum Lp(a) level s in the patients was different from that in the control group, and no prognostic tendency of serum Lp(a) levels was noted by the etiology o f renal failure as histologically determined by the renal biopsies. In the patient group, we also found that serum Lp(a) levels negatively c orrelated with serum triglycerides (TG) and total protein (TP) concent rations (p < 0.05), but no correlation was found between the duration of hemodialysis therapy or patient age and the serum levels of TC, TG, apo B and Lp(a) levels when tested for simple regression. Significant (p < 0.05) positive correlations were also found between TP and serum TG, apo B, and LCAT activities. These opposing tendencies of Lp(a) an d serum TG, apo B, when measured against TP concentrations, indicate t hat serum TP levels may not affect serum lipoprotein and Lp(a) levels in the same direction. These data suggest that hemodialysis or end-sta ge renal disease itself, rather than hypoproteinemia, may hold the key to high serum Lp(a) levels in hemodialysis patients.