Apo(a) Phenotypes and Lp(a) Concentrations in Renal Transplant Patients

Kandoussi, Abdelmejid; Hugue, V.; Cachera, C; Hazzan, Marc; Dracon, M; Tacquet, A; Noël, Christian

doi:10.1159/000045164

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…Apo(a) isoform sizes were determined by comparison of their sizes with an apo(a) standard (Immuno-AG) electrophoresed on each gel which contained 5 different isoforms. Low molecular weight (LMW) apo(a) phenotypes included all subjects who had at least one of the isoforms F, B, S1 or S2, whereas the high molecular weight (HMW) apo(a) phenotypes included all subjects with only S3 or S4 isoforms or with null type [21,25,26]. …”

Section: Methodsmentioning

confidence: 99%

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et al. 2004

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Malnutrition, anemia and increased atherosclerosis are the main causes of mortality in hemodialysis patients. Therapies designed to improve the disorders might therefore be expected to improve outcome. The effects of Nandrolone Decanoate (ND), in 64 stable hemodialysis patients, were studied with respect to the following parameters: nutritional status, hematological indexes, lipid profiles including serum levels of lipoprotein(a) [Lp(a)] in terms of differences in apolipoprotein(a) [apo(a)]. The patients were treated with ND at dose of 100 mg/I.M./week for 4 months. After 2 and 4 months of treatment the elevations in the serum levels of albumin (p < 0.0001), creatinine (p < 0.009), hemoglobin (p < 0.03), hematocrit (p < 0.03), cholesterol (p = 0.007) and triglyceride (p < 0.04) were noticed. Marked decrease in the concentration of high-density lipoprotein cholesterol (p = 0.007) and Lp(a) (p < 0.0001) were also found. These effects after 2 months of treatment withdrawal were relatively constant. By dividing patients according to the baseline Lp(a) levels and molecular weight of apo(a) isoform, it was noticed that the decrease in serum Lp(a) was significant in patients with high Lp(a) (>30 mg/dl) than those of with low Lp(a) (<30 mg/dl), irrespective of apo(a) molecular weight. It may be suggested that, ND has beneficial effect on nutritional status and treatment of anemia in hemodialysis patients. In spite the adverse effect of ND on lipid profile, it decreases Lp(a) mostly in patients with high serum Lp(a) preferently by the effect on apo(a) gene transcriptional activity.

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Section: Methodsmentioning

confidence: 99%

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et al. 2004

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“…Kandoussi et al (22) reported that successful transplantation leads rapidly to a correction of Lp(a), probably in relation to the improvement of the renal function, suggesting an active role of the kidney in Lp(a) metabolism. In healthy people the serum level of Lp(a) has been shown to depend basically on its hepatic synthesis (8,23).…”

Section: Parametersmentioning

confidence: 99%

“…In CRF patients an accumulation of Lp(a) fragments or a reduction in their metabolism might occur (8,26). The most important factor seems to be the low molecular weight status corresponding to high Lp(a) levels (22). The kidney may influence the Lp(a) metabolism through either secretion of a factor that regulates Lp(a) synthesis (27) or the presence of uremic toxins that can influence regulatory mechanism synthesis and /or the catabolic pathways (6).…”

Section: Parametersmentioning

confidence: 99%

Concentration of Lp(a) and other Apolipoproteins in Predialysis, Hemodialysis, Chronic Ambulatory Peritoneal Dialysis and Post-Transplant Patients

Kimak¹,

Solski²,

Janicka³

et al. 2000

CCLM

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Serum levels of lipids, lipoprotein(a) Lp(a) and other apolipoproteins were determined in 47 predialysis patients, 40 hemodialysis (HD) patients, 39 chronic ambulatory peritoneal dialysis (CAPD) patients, 11 patients after kidney transplantation and 47 healthy subjects as reference group. The predialysis, HD, and CAPD patients had disturbances in the concentration of serum triglyceride (TG), high density lipoprotein (HDL)-cholesterol, apolipoprotein AI (apoAI), total apoCIII, apoCIII present in the particles without apoB (apoCIII non B), and Lp(a) and HDL-cholesterol, low density lipoprotein (LDL)-cholesterol/HDL-cholesterol, HDL-cholesterol/apoAI, apoAI/apoB, and apoAI/apoCIII ratios. Predialysis patients had significantly lower concentrations of HDL-cholesterol and total apoE levels than CAPD patients and total apoE level than HD patients. Moreover, both HD and CAPD patients had significantly increased levels of apoB containing apoE (apoB:E) and apoB containing apoCIII (apoB:CIII). The concentrations of serum TG, total cholesterol, LDL-cholesterol, apoB, Lp(a) in CAPD patients were statistically higher than in HD patients. The patients after transplantation demonstrated normalization of lipid and lipoprotein parameters and lipoprotein ratios except serum levels of TG, total apoCIII, apoCIII non B and the apoAI/apoCIII ratio. We concluded that abnormal lipid and lipoprotein concentrations in patients with uremia may be the cause of their high risk of atherosclerosis, but posttransplant patients exhibited improved levels of serum lipids, Lp(a) and other lipoprotein parameters and lipoprotein composition, which could be an index of decreased atherogenic status.

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“…Plasma Lp(a) concentrations usually increase in patients with severe end-stage renal disease but, although it is known that Lp(a) levels in patients with chronic renal failure are higher than in normal controls, the precise mechanism underlying this phenomenon is unclear (17). A successful transplantation corrects Lp(a) levels probably as a result of improved renal function, thus suggesting that the kidney plays an active role in Lp(a) metabolism (17)(18)(19)(20). rhGH may be used to help growth-retarded children after renal transplant (21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and growth hormone is important in the regulation of fat metabolism (31)(32)(33).…”

Section: Introductionmentioning

confidence: 99%

Lipid profile during rhGH therapy in pediatric renal transplant patients

Ghio¹,

Damiani²,

Garavaglia³

et al. 2002

Pediatric Transplantation

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To evaluate the effect of recombinant human growth hormone (rhGH) treatment on the lipid profile of pediatric renal transplant patients, we studied nine children treated with rhGH for 1 yr and a control group of 12 untreated patients matched in terms of age, renal transplant function and post-transplant follow-up. The levels of lipoprotein (a [Lp(a)], cholesterol, triglycerides, apolipoprotein A (APO A) and apolipoprotein B (APO B), and the APO B/APO A ratio, were determined at baseline and after 6 and 12 months of follow-up. RhGH therapy had no effect on cholesterol, triglycerides or apolipoproteins. Mean serum Lp(a) levels increased from 6.7 +/- 5.7 mg/dL at baseline to 11.8 +/- 10.7 after 6 months (p = 0.018) and 13.6 +/- 15.1 after 12 months of rhGH treatment (p = 0.04), but did not change in the control group. Lp(a) is a risk factor for cardiovascular morbidity, and increased Lp(a) levels may be a side-effect of rhGH treatment in renal transplant patients. Although long-term follow-up of a large number of patients is needed to establish the duration and extent of the effects of rhGH treatment on Lp(a) levels in transplanted children, serum Lp(a) levels should be carefully monitored in those receiving rhGH therapy.

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Apo(a) Phenotypes and Lp(a) Concentrations in Renal Transplant Patients

Cited by 6 publications

References 21 publications

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Concentration of Lp(a) and other Apolipoproteins in Predialysis, Hemodialysis, Chronic Ambulatory Peritoneal Dialysis and Post-Transplant Patients

Lipid profile during rhGH therapy in pediatric renal transplant patients

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