Longitudinal survey of apolipoproteins and atherogenic risk in hemodialysis and continuous ambulatory peritoneal dialysis patients.
Total cholesterol (TC) and HDL-cholesterol (HDL-C) have been studied in dialysis patients, but a systematic study of apolipoprotein (apo) A-I, apo B, and the anti-atherogenic risk ratio, apo A-I/apo B, over time has not been done. We report lipid and apo values over 12-14 months in 55 hemodialysis (HD) and 40 continuous ambulatory peritoneal dialysis (CAPD) patients. For HD patients, mean TC fell, but not significantly, and HDL-C and TC/HDL-C, an atherogenic risk ratio, did not change over time. Apo A-I/apo B correlated with months on HD (r = 0.30, p less than 0.04) and rose significantly (p less than 0.005) during the study period. Paired t-test analysis by race, gender, and diabetes showed that in nondiabetics, apo A-I rose, apo B fell (p less than 0.05), and apo A-I/apo B improved (p less than 0.002). Similar trends were seen in all subgroups except for diabetics. For CAPD patients, total months of treatment correlated with TC/HDL-C (r = 0.46, p less than 0.05) and with HDL-C (r = -0.53, p less than 0.02), but paired t-test analysis of longitudinal data showed no significant changes in TC, HDL-C, apo A-I, apo B, TC/HDL-C, or apo A-I/apo B. The lipoprotein patterns of all patients who died were not significantly different from those of the surviving patients. Our longitudinal data reveal that lipids, apolipoproteins, and risk ratios remain stable over time on HD and CAPD. In fact, the anti-atherogenic index of apo A-I/apo B improved in HD patients, especially in nondiabetics.
Burrell
D
D
Division of Nephrology, Long Island College Hospital, Brooklyn, New York 11201.
Antignani
A
A
Fein
P A
PA
Goldwasser
P
P
Mittman
N
N
Avram
M M
MM
D000328:Adult; D000368:Aged; D016632:Apolipoprotein A-I; D001053:Apolipoproteins / Q000097:blood*; D001054:Apolipoproteins A / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D001161:Arteriosclerosis / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D012307:Risk Factors
D016632:Apolipoprotein A-I; D001053:Apolipoproteins; D001054:Apolipoproteins A; D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D002784:Cholesterol