Lipoprotein (a) in Chronic Renal Failure: Effect of Maintenance Hemodialysis

Kalra, Om Prakash; Khaira, Ambar; Gambhir, Jasvinder K.; Agarwal, Sarla; Bhargava, Satish

doi:10.1046/j.1492-7535.2003.00057.x

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…Elevated Lp (a) levels in subjects with early impairment of renal function are associated with greater prevalence of CVD (18). Lp (a) levels were higher than controls in all the groups in this study, which is in agreement with Kalra et al reported that Lp(a) levels starts increasing early during the course of CKD and becomes pronounced with increasing severity of disease (19).…”

Section: Discussionsupporting

confidence: 93%

Lipid abnormalities, lipoprotein (a) and apoprotein pattern in non-dialyzed patients with chronic kidney disease

Rao

Bitla

Reddy

et al. 2010

Indian J Clin Biochem

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The present study was carried out to explore the altered lipid, lipoprotein and apoprotein abnormalities along with lipoprotein (a) in chronic kidney disease patients with stage I to V which were further divided into group 1 (stage I and II), group 2 (stage III and IV) and group 3 (stage V). 50 chronic kidney disease patients with stage I to V and 20 healthy normal subjects as controls were recruited for this study. Among the various parameters tested triglyceride levels were high in group 1 and 2, whereas VLDL cholesterol, Lp (a) and apo B levels were significantly high in all the groups when compared to controls (P<0.05). However, LDL cholesterol level was significantly low in group 3 only as compared to control group (P<0.05). Apoprotein AI values also showed significant decrease in all groups as compared to controls (P<0.05). Though total cholesterol levels in group 1 and LDL levels in group 1 and 2 were higher than controls, but the values attained not statistically significant (P>0.05). In conclusion high levels of VLDL cholesterol, Lp (a), apo B and low levels of apoprotein AI as reported in this study are the major lipid disorders in the development of cardiovascular complications at all the stages in these patients.

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Section: Discussionsupporting

confidence: 93%

Lipid abnormalities, lipoprotein (a) and apoprotein pattern in non-dialyzed patients with chronic kidney disease

Rao

Bitla

Reddy

et al. 2010

Indian J Clin Biochem

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“…20 In CRF, besides other lipid abnormalities, there is significant increase in the level of serum Lp(a). 8 Dialysis therapy may increases Lp(a) 10 or decreases Lp(a) level. 8,11 Some studies also reported that Lp(a) level did not vary before and after hemodialysis.…”

Section: Discussionmentioning

confidence: 99%

“…8 Dialysis therapy may increases Lp(a) 10 or decreases Lp(a) level. 8,11 Some studies also reported that Lp(a) level did not vary before and after hemodialysis. 5,12 In our study we find elevated levels of Lp(a) in CRF patients with and without hemodialysis as compared to controls.…”

Section: Discussionmentioning

confidence: 99%

“…6 Controversies exist regarding Lp(a) levels in CRF patients with and without hemodialysis. There are few studies that showed Lp(a) levels were elevated in CRF patients, 7,8,9 Lp(a) levels were elevated in hemodialysed patients, 10 Lp(a) levels were decreased after hemodialysis 8,11 and Lp(a) levels did not vary before and after hemodialysis. 5,12 With the implication of plasma lipids and lipoproteins in the pathogenesis of atherosclerosis and ischemic heart disease, it becomes worthwhile to study the behavior of various lipid fractions in CRF patients.…”

Section: Introductionmentioning

confidence: 98%

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Lipid profile and lipoprotein(a) in chronic renal failure patients with and without hemodialysis

Sharma¹,

Shah²,

Gorasia

et al. 2012

IJMEDPH

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Objectives: Chronic renal failure (CRF) is complicated by characteristic dyslipidemias. CRF patients on hemodialysis have abnormalities in lipid profile and have a high incidence of cardiovascular diseases. Lipoprotein(a) [Lp(a)] is now considered as a novel cardiovascular risk factor and its level is increased in CRF patients with and without hemodialysis. We sought to evaluate the pattern of lipid profile including Lp(a) level in CRF patients with and without hemodialysis. Methodology: Study were divided into 3 groups, Group-I: healthy controls (30), Group-II: CRF patients who never undergone hemodialysis (30) and Group-III: CRF patients on hemodialysis for more than 6 months (30). We obtained serum samples from patients in the morning after an overnight fast and were analysed for total cholesterol (TC), triglycerides (TGs), HDL, LDL, Lp(a) using standard colorimetric assays on fully automated analyzer. VLDL concentration was calculated using Friedewald's Formula. Results: Among the various parameters tested triglyceride and VLDL levels were significantly higher in group-II and III as compared to controls (p<0.01). HDL levels were significantly lower in group-II and III as compared to control (p<0.05). HDL level was found reduced in group-III as compared to Group-II (p<0.01). There was no significant change (p>0.05) observed in total cholesterol and LDL levels in between healthy controls and CRF patients with & without hemodialysis. Lp(a) levels were significantly higher in group-II and III as compared to controls (p<0.01) but the difference between Lp(a) levels in group-II and III was found insignificant (p>0.05). There was no significant difference (p>0.05) observed between Lp(a) levels and lipid profile in male and female patients in control group and in CRF patients with and without hemodialysis. Conclusions: This study demonstrated that CRF patients with and without hemodialysis are at greater risk of development of dyslipidemias, characterized by hypertriglyceridemia, elevated VLDL and Lp(a) levels and decreased HDL levels. Total cholesterol and LDL cholesterol levels remain normal or decreased in these patients. Both male and female patients of CRF with and without hemodialysis have dyslipidemias without any discrimination of sex and it is not attenuated by the hemodialysis process.

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“…[11–13] There are no suitable interventions or therapies available to decrease plasma Lp(a) levels; however, we have shown a variable decrease in plasma Lp(a) after starting maintenance hemodialysis (MHD). [12]…”

Section: Introductionmentioning

confidence: 99%

Association between high molecular weight apolipoprotein isoforms and lipoprotein levels in advanced chronic kidney disease and the effect of hemodialysis

et al. 2013

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To explore the association between high molecular weight apo(a) isoforms and lipoprotein(a) [Lp(a)] in chronic kidney disease (CKD) and the effect of maintenance hemodialysis (MHD), plasma Lp(a) and apo(a) isoforms were determined in age and sex-matched CKD stage 4 and stage 5 patients (repeated after 4 weeks of MHD) and healthy controls (n = 18). Median Lp(a) increased with severity of CKD. Upon HMW apo(a) isoform stratification, Lp(a) in S2 isoform group was 37.6 mg/dl in CKD stage 4 and 64.0 mg/dl in stage 5 (P < 0.024 and P < 0.001 vs. controls), whereas in S3 + S4 group there was no significant increase. Following MHD, Lp(a) also decreased significantly only in the S2 group. Increase in Lp(a) in CKD patients with HMW apo(a) isoforms is mainly restricted to S2 isoform group, furthermore, decrease in Lp(a) levels in response to MHD is also seen in this group only.

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Lipoprotein (a) in Chronic Renal Failure: Effect of Maintenance Hemodialysis

Abstract: The results of this study show that increases in Lp(a) levels start early during the course of CKD and become more pronounced with increased severity of disease. Initiation of MHD lowers Lp(a) levels and may have a long-term beneficial effect on cardiovascular morbidity and mortality.

Cited by 7 publications

References 28 publications

Lipid abnormalities, lipoprotein (a) and apoprotein pattern in non-dialyzed patients with chronic kidney disease

Lipid abnormalities, lipoprotein (a) and apoprotein pattern in non-dialyzed patients with chronic kidney disease

Lipid profile and lipoprotein(a) in chronic renal failure patients with and without hemodialysis

Association between high molecular weight apolipoprotein isoforms and lipoprotein levels in advanced chronic kidney disease and the effect of hemodialysis

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