Objective: To investigate whether the specific lipoprotein (LP) abnormaliti
es of peritoneal dialysis (PD) are associated with functional variables of
this mode of dialysis.
Design: A survey of the LP profile in relation to peritoneal dialysis capac
ity (PDC) variables. The LP profile was compared to that of a group of age-
and sex-matched controls.
Setting: The Peritoneal Dialysis Unit at Sahlgrenska University Hospital in
Gothenburg, Sweden.
Patients: Twenty-two nondiabetic PD patients (5 women, 17 men) who had been
on PD for at least 6 months.
Main Outcome Measures: The LP profile included plasma lipids, apolipoprotei
ns (Apo), and individual ApoA- and ApoB-containing LP. The PDC measurement
determined peritoneal glucose uptake, protein losses, effective peritoneal
surface area, and total weekly creatinine clearance.
Results:The patients had been on PD for 6 to 48 months (mean 15.3 months) a
nd had a total weekly creatinine clearance of 69.7 +/- 13.3 L/1.73m(2) body
surface area, an average peritoneal glucose uptake corresponding to 446 +/
- 162 kcal/24 hour, and a protein loss of 8.1 +/- 2.5 g/24 hr. The patients
had significantly higher total cholesterol (7.1 mmol/L), VLDL-cholesterol
(1.0 mmol/L), LDL-cholesterol (4.7 mmol/L), and triglyceride levels (2.5 mm
ol/L); whereas the HDL-cholesterol level (1.2 mmol/L) was significantly low
er than in controls. The PD patients had increased levels of ApoB-containin
g LPs, both of the cholesterol-rich LP-B and of the triglyceride-rich LP-B
complex, reflected in higher plasma concentrations of ApoB, ApoC-III, and A
poE. Furthermore, they had significantly lower levels of LP-A-I:A-II, as we
ll as of ApoA-I and ApoA-II. The LP-A-I:A-II and ApoA-II levels correlated
inversely with the duration of PD treatment (r = 0.54, p < 0.01 and r = 0.5
2, p < 0.05, respectively). The ApoA-II level was inversely correlated with
the peritoneal surface area (r = 0.53, p < 0.05). There were no other corr
elations between LP variables and PDC variables, nor did any of the LP vari
ables correlate with peritoneal glucose uptake or protein losses.
Conclusion: The proatherogenic lipoprotein profile of patients on PD is cha
racterized by increased concentrations of cholesterol-rich and triglyceride
-rich ApoB-containing LPs. While the duration of treatment appears to have
some influence on the development of this type of dyslipidemia, the pathoph
ysiological links to the dialysis mode must be further explored.