LIPOPROTEIN (A) IN PATIENTS ON MAINTENANCE HEMODIALYSIS AND CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

Lipoprotein (a) concentrations and apoprotein (a) isoforms were measur ed in 99 haemodialysis and 79 peritoneal dialysis patients and compare d with a normal population. Peritoneal dialysis patients demonstrated a threefold and haemodialysis a twofold increase in median Lp(a) value s compared to controls (P less-than-or-equal-to 0.001). The peritoneal dialysis group had significantly more patients with Lp(a) values grea ter than 30 mg/dl compared to controls, (53% versus 22% P less-than-or -equal-to 0.001). In addition both patient groups demonstrated signifi cant' hypertriglyceridaemia (P less-than-or-equal-to 0.001), reduction in HDL (P less-than-or-equal-to 0.001) and elevation of the cholester ol/HDL ratio (P less-than-or-equal-to 0.001) compared with controls. P eritoneal dialysis patients also demonstrated significant hypercholest erolaemia (P less-than-or-equal-to 0.003). Lipoprotein (a) concentrati ons are considerably elevated in patients on maintenance dialysis and this occurs in addition to the typical lipoprotein disturbances. This elevation may increase vascular risk, particularly in the peritoneal d ialysis group who also have hypercholesterolaemia and reduced HDL.