High lipoprotein (a) levels in chronic hemodialysis patients are closely related to the acute phase reaction.
To study the mechanism underlying the high lipoprotein (a) [Lp(a)] level in uremic patients on chronic hemodialysis, we investigated the levels of Lp(a), acute phase reactants (C-reactive protein and sialic acid), and interleukin-6 (IL-6) in 54 dialysis patients. The mean [95% CI] Lp(a) level was increased in the hemodialysis patients compared with the 30 controls (30 [25-36] vs. 18 [14-23] mg/dl, p < 0.005). Among dialysis patients, 46% had an Lp(a) level > 30 mg/dl, which was significantly higher than the percentage in the control group (17%). The levels of C-reactive protein, sialic acid, and IL-6 were also increased in dialysis subjects compared with controls (200 [134-299] vs. 37 [24-58] micrograms/dl, p < 0.0001; 63 [59-66] vs. 54 [52-56] mg/dl, p < 0.002; and 9.2 [7.8-11] vs. 5.5 [5.0-6.1] pg/ml, p < 0.0005, respectively). The Lp(a) level was positively correlated with that of C-reactive protein (r = 0.415, p < 0.002), sialic acid (r = 0.426, p < 0.002), and IL-6 (r = 0.298, p < 0.05) in the hemodialysis patients, but not in the controls or non-dialysis uremic patients. The Lp(a) level in the dialysis patients was also positively correlated with activation markers of coagulation (thrombin-antithrombin III complex and plasmin-alpha 2-plasmin inhibitor complex, p < 0.005). These results indicate that the Lp(a) level is closely related to the acute phase reaction and hypercoagulability in chronic hemodialysis patients.
Kario
K
K
Department of Internal Medicine, Hyogo Prefectural Awaji Hospital, Japan.
Matsuo
T
T
Kobayashi
H
H
Matsuo
M
M
Asada
R
R
Koide
M
M
D000210:Acute-Phase Reaction / Q000097:blood* / Q000209:etiology; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019158:N-Acetylneuraminic Acid; D006435:Renal Dialysis / Q000009:adverse effects*; D012794:Sialic Acids / Q000097:blood; D014511:Uremia / Q000097:blood / Q000628:therapy*
D015415:Biomarkers; D015850:Interleukin-6; D017270:Lipoprotein(a); D012794:Sialic Acids; D002097:C-Reactive Protein; D019158:N-Acetylneuraminic Acid