Early renal failure as a cardiovascular disease: Focus on lipoprotein(a) and prothrombotic state

Catena, Cristiana

doi:10.5527/wjn.v4.i3.374

Cited by 10 publications

(6 citation statements)

References 39 publications

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“…Support to a possible role of Lp(a) in the development and progression of renal dysfunction has been provided also in other studies [203,204], although in the Chronic Renal Insufficiency Cohort (CRIC) study that enrolled 3939 adults with chronic kidney disease, mostly diabetics, none of the circulating lipids, including Lp(a), were significantly associated with progression of kidney disease [205]. Further work is needed to better understand the complex relationship between Lp(a) and renal disease, although it should be kept in mind that increased Lp(a) levels are one the main contributors to the increased cardiovascular risk found in patients with progressive renal disease [206].…”

Section: Lp(a) and Hypertensive Renal Damagementioning

confidence: 99%

Lipoprotein(a): Just an Innocent Bystander in Arterial Hypertension?

Brosolo,

Da Porto,

Marcante

et al. 2023

IJMS

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Elevated plasma lipoprotein(a) [Lp(a)] is a relatively common and highly heritable trait conferring individuals time-dependent risk of developing atherosclerotic cardiovascular disease (CVD). Following its first description, Lp(a) triggered enormous scientific interest in the late 1980s, subsequently dampened in the mid-1990s by controversial findings of some prospective studies. It was only in the last decade that a large body of evidence has provided strong arguments for a causal and independent association between elevated Lp(a) levels and CVD, causing renewed interest in this lipoprotein as an emerging risk factor with a likely contribution to cardiovascular residual risk. Accordingly, the 2022 consensus statement of the European Atherosclerosis Society has suggested inclusion of Lp(a) measurement in global risk estimation. The development of highly effective Lp(a)-lowering drugs (e.g., antisense oligonucleotides and small interfering RNA, both blocking LPA gene expression) which are still under assessment in phase 3 trials, will provide a unique opportunity to reduce “residual cardiovascular risk” in high-risk populations, including patients with arterial hypertension. The current evidence in support of a specific role of Lp(a) in hypertension is somehow controversial and this narrative review aims to overview the general mechanisms relating Lp(a) to blood pressure regulation and hypertension-related cardiovascular and renal damage.

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Section: Lp(a) and Hypertensive Renal Damagementioning

confidence: 99%

Lipoprotein(a): Just an Innocent Bystander in Arterial Hypertension?

Brosolo,

Da Porto,

Marcante

et al. 2023

IJMS

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“…The association between kidney function and lipoprotein(a) levels has received interest since the initial observation of elevated lipoprotein(a) levels among dialysis patients in the end of 20th century (26). Previous studies showed the association of eGFR and lipoprotein(a) that higher lipoprotein(a) levels have been observed with reduced eGFR, even in the earliest stages of renal impairment (24,(27)(28)(29)(30)(31). Our results also show that there is an inverse correlation between lipoprotein(a) and eGFR in patients undergoing CAG.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the potential effects of lipoproteins and statins, our study has adjusted for those potential confounders. The possible underlying mechanism may be lipoprotein(a) potentially constitutes a molecular link between the processes of atherosclerosis (mediated by the LDL-like moiety) and thrombosis [mediated by the apo(a) moiety] that together precipitate events such as myocardial infarction and ischemic stroke ( 24 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

Association of Lipoprotein(a)-Associated Mortality and the Estimated Glomerular Filtration Rate Level in Patients Undergoing Coronary Angiography: A 51,500 Cohort Study

Huang

Yang

et al. 2021

Front. Cardiovasc. Med.

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Background: High lipoprotein(a) is associated with poor prognosis in patients at high risk for cardiovascular disease. Renal function based on the estimated glomerular filtration rate (eGFR) is a potential risk factor for the change of lipoprotein(a). However, the regulatory effect of eGFR stratification on lipoprotein(a)-associated mortality has not been adequately addressed.Methods: 51,500 patients who underwent coronary angiography (CAG) or percutaneous coronary intervention (PCI) were included from the Cardiorenal ImprovemeNt (CIN) study (ClinicalTrials.gov NCT04407936). These patients were grouped according to lipoprotein(a) quartiles (Q1–Q4) stratified by eGFR categories (<60 and ≥60 mL/min/1.73m2). Cox regression models were used to estimate hazard ratios (HR) for mortality across combined eGFR and lipoprotein(a) categories.Results: The mean age of the study population was 62.3 ± 10.6 years, 31.3% were female (n = 16,112). During a median follow-up of 5.0 years (interquartile range: 3.0–7.6 years), 13.0% (n = 6,695) of patients died. Compared with lipoprotein(a) Q1, lipoprotein(a) Q2–Q4 was associated with 10% increased adjusted risk of death in all patients (HR: 1.10 [95% CI: 1.03–1.17]), and was strongly associated with about 23% increased adjusted risk of death in patients with eGFR <60 mL/min/1.73m2 (HR: 1.23 [95% CI: 1.08–1.39]), while such association was not significant in patients with eGFR ≥60 mL/min/1.73m2 (HR: 1.05 [95% CI: 0.97–1.13]). P for interaction between lipoprotein(a) (Q1 vs. Q2–Q4) and eGFR (≥60 vs. eGFR <60 mL/min/1.73m2) on all-cause mortality was 0.019.Conclusions: Elevated lipoprotein(a) was associated with increased risk of all-cause mortality and such an association was modified by the baseline eGFR in CAG patients. More attention should be paid to the patients with reduced eGFR and elevated lipoprotein(a), and the appropriate lipoprotein(a) intervention is required.

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“…The latter mechanism is the decreased renal scavenging capability of Lp(a) in patients with renal failure, which has been demonstrated by the distribution difference of the plasma Lp(a) concentration in renal arteries and veins and by the urine apolipoprotein A fragments (22). Such a negative correlation between Lp(a) levels and renal function, triggering a vicious circle, leads to CVEs even in patients with early renal impairment (22,24).…”

Section: Discussionmentioning

confidence: 99%

Predictive value of procalcitonin in chronic allograft dysfunction in kidney transplant recipients

et al. 2019

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The present study was designed to determine the potential role of circulating procalcitonin (PCT) in predicting chronic allograft dysfunction (CAD) in kidney transplant recipients (KTRs). A total of 87 KTRs were retrospectively analyzed and divided into a CAD and a non-CAD (normal renal function) group. Clinical features and inflammatory markers were compared between the groups, including PCT, white blood cell count, C-reactive protein, neutrophil percentage (N%) and lipoprotein(a) [Lp(a)], and the receiver operating characteristic (ROC) curve for CAD prediction was plotted. Univariate and multivariate logistic regression analyses were used to analyze the relevant risk factors for CAD. The results indicated that i) the values of these indicators in the CAD group, including the male ratio, years after transplantation, PCT, N% and Lp(a), were significantly higher than those in the non-CAD group, while the body mass index, aspartate aminotransferase, high-density lipoprotein and low-density lipoprotein were significantly lower; ii) PCT and Lp(a) were able to predict CAD with an area under the ROC curve of 0.893 and 0.770, respectively; iii) multivariate logistic regression analysis of factors influencing CAD in KTRs suggested that elevated PCT was an independent risk factor. In KTRs, PCT was identified as a potential biomarker for predicting CAD.

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Early renal failure as a cardiovascular disease: Focus on lipoprotein(a) and prothrombotic state

Cited by 10 publications

References 39 publications

Lipoprotein(a): Just an Innocent Bystander in Arterial Hypertension?

Lipoprotein(a): Just an Innocent Bystander in Arterial Hypertension?

Association of Lipoprotein(a)-Associated Mortality and the Estimated Glomerular Filtration Rate Level in Patients Undergoing Coronary Angiography: A 51,500 Cohort Study

Predictive value of procalcitonin in chronic allograft dysfunction in kidney transplant recipients

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