Lipoproteins in Children Treated with Continuous Peritoneal Dialysis

Abstract

ABSTRACT. Total lipids, lipoprotein-lipids, and apolipo-VLDL-C, cholesterol in the VLDL fraction proteins were studied in plasma of 20 patients, aged 13.9VLDL-TG, triglycerides in the VLDL fraction f 3.4 y (mean f SD, range 7.4 to 19 y), who were treated with continuous peritoneal dialysis for a period of 2.1 2 1.2 (range 0.5 to 4.9) y. Measurements included total plasma cholesterol and triglycerides, triglycerides in the very low density fraction, and cholesterol in the very low density, low density, and high density fractions, as well as Hyperlipoproteinemia is present in the majority of adult ( I ) apo A-I and apo B. The results were compared with values and pediatric (2) patients with end stage renal disease. This in 17 healthy control subjects, aged 13.0 f 5.1 (range 5.1 metabolic disturbance is of particular significance because several to 19) y. The patients had significantly elevated levels of epidemiologic studies have shown a correlation between plasma total plasma triglycerides, triglycerides in the very low lipoprotein concentrations and the occurrence of atherosclerosis density fraction, total plasma cholesterol, cholesterol in in the general population. In these studies, HDL, as well as the the very low density fraction, and cholesterol in the low main protein in this fraction, apo A-I, were associated with a density fraction, whereas levels of cholesterol in the high protective effect against atherosclerosis, whereas high levels of LDL and apo B were found to increase the risk for atherosclerosis density fraction were normal. Plasma apo B levels were ,-, elevated, but apo A-I levels were not different from controls. In addition, the nutritional status of the patients was CAPD and CCPD are now widely accepted treatment modalassessed and apo A-I and apo B concentrations were measities for children with end stage renal disease. It has been demured in the dialysate of 10 patients. The losses of apo A-I onstrated that total serum lipid levels in these patients are eleand apo B in dialysate averaged 13.4 2 7.4 and 2.1 f 3.1 vated at the initiation of dialysis treatment (4) and are not mg/kg/d, respectively. Lipoprotein profiles were not cor-significantly influenced by treatment with CAPD/CCPD over a related with nutritional status. We conclude that pediatric 24-mo period (5). However, lipid levels in the different lipopro-

Carnitine supplementation improves apolipoprotein B levels in pediatric peritoneal dialysis patients

“…Elevated TG and total cholesterol levels have been reported in 63%-100% and 30%-100% of pediatric PD patients, respectively [27,28,29]. The present study confirms the high prevalence of hypertriglyceridemia and hypercholesterolemia in these patients.…”

“…Although some studies revealed decreased HDL cholesterol levels [30,31], in this study there was no significant difference between the treatment group and the healthy controls. In previous studies of pediatric PD patients, apo A-I levels were found to be similar [28,30] or reduced [31], while apo B levels were elevated [28,30] compared with control subjects. Highly elevated levels of apo B were noted in our analysis, while apo A-I was normal.…”

Metabolic effects of erythropoietin in patients on peritoneal dialysis

“…The elevated plasma triglycerides, total cholesterol, LDL-cholesterol, and Apo B concentrations in patients in the present study before EPO are compatible with previous reports of type IV hyperlipidemia in patients with ESRD [34]. Pollock et al [35] studied 112 patients on hemodialysis before and after 6 and 12 months of EPO and found significant decreases in plasma triglycerides, cholesterol, and Apo B following correction of anemia.…”

“…Hypertriglyceridemia and hyperlipoproteinemia are common in patients with uremia on peritoneal dialysis [33,34]. The elevated plasma triglycerides, total cholesterol, LDL-cholesterol, and Apo B concentrations in patients in the present study before EPO are compatible with previous reports of type IV hyperlipidemia in patients with ESRD [34].…”

Long-term outcome of chronic dialysis in children

“…In a population of young PD patients, Scolnik and Balfe have shown that average serum cholesterol and triglyceride levels were 27% and 122% higher than the age-related normal levels [111]. Also, peritoneal losses of the low molecular weight lipoproteins results in lower levels of the protective high-density lipoproteins (HDLs) [75, 112]. In a similar study of adults the triglyceride, but not cholesterol, levels at initiation of dialysis were strong predictors of survival [113].…”