DETECTION OF SERUM AND URINARY LIPOPROTEIN(A) IN PATIENTS WITH RENAL DISEASES

We measured and analysed serum and urinary lipoprotein(a) [Lp(a)] in 7 3 patients with various renal diseases, and 168 control subjects. The results revealed that serum Lp(a) levels were significantly elevated i n patients with mesangial proliferative glomerulonephritis, membranous nephropathy, chronic renal failure and diabetic nephropathy, except p atients with IgA nephropathy (IgAN) with gross haematuria. Serum Lp(a) concentrations were found to be significantly correlated with serum a lbumin (r= -0.5033, P<0.001) and urinary protein excretion (r = 0.3541 , P<0.005), while not with serum creatinine (r = - 0.0144, P>0.05). Pa tients with selective urinary protein excretion had a lower serum Lp(a ) level than those with non-selective urinary protein excretion. The c orrelation between serum albumin and serum Lp(a) levels remained signi ficant (P<0.001) after adjustment for serum creatinine, urinary protei n excretion and the selectivity of urinary protein by multivariate reg ression analysis. Urinary Lp(a) excretion was decreased and related to the serum creatinine level (r= -0.312, P<0.01). Our conclusion is tha t renal patients with proteinuria and hypoalbuminemia tend to have ele vated levels of Lp(a) which are more significantly correlated to serum albumin levels than other parameters such as serum 24-h urinary prote in, selectivity of urinary protein and serum creatinine; while urinary Lp(a) excretion varies inversely with serum creatinine levels.