Increased serum lipoprotein(a) levels in patients with early renal failure.
BACKGROUND
Elevated serum lipoprotein(a) levels have been found in patients with end-stage renal disease and in patients undergoing dialysis, suggesting that this lipoprotein contributes to the increased cardiovascular risk seen in these patients. It is not known whether lipoprotein(a) levels are elevated in the early phases of renal disease.


OBJECTIVE
To evaluate levels of lipoprotein(a) and other lipids and the prevalence of atherosclerotic disease in patients with early renal failure.


METHODS
Cross-sectional study.


METHODS
Hypertension clinic of a university medical center.


METHODS
257 patients with normal renal function and 160 patients with early impairment of renal function (creatinine clearance, 30 to 89 mL/min per 1.73 m2 of body surface area).


METHODS
Renal function was assessed by 24-hour creatinine clearance, proteinuria, and microalbuminuria. Cardiovascular disease status was also assessed. Serum lipoprotein(a), lipids, apolipoproteins, and apolipoprotein(a) isoforms were measured.


RESULTS
Age, blood pressure, and serum lipoprotein(a) levels were greater in patients with early renal failure than in those with normal renal function and were independently associated with the presence of decreased creatinine clearance. Serum lipoprotein(a) and creatinine clearance were inversely correlated. The prevalence of coronary artery, cerebrovascular, and peripheral vascular disease was greater in patients with early renal failure than in those with normal renal function. The frequency distribution of apolipoprotein(a) isoforms was similar in patients with normal and those with impaired renal function.


CONCLUSIONS
Serum lipoprotein(a) levels are elevated in patients with early impairment of renal function and are associated with greater prevalence of cardiovascular disease. An inverse correlation between serum lipoprotein(a) level and creatinine clearance and a frequency distribution of apolipoprotein(a) isoforms similar to that of normal patients point to decreased renal catabolism as a probable mechanism of lipoprotein(a) elevation in patients with early renal failure.
Sechi
L A
LA
Department of Internal Medicine, University of Udine School of Medicine, Ospedale Civile, Padiglione Medicine, Italy. sechi@uniud.it
Zingaro
L
L
De Carli
S
S
Sechi
G
G
Catena
C
C
Falleti
E
E
Dell'Anna
E
E
Bartoli
E
E
D000328:Adult; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000209:etiology*; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007677:Kidney Function Tests; D008055:Lipids / Q000097:blood; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000652:urine; D051437:Renal Insufficiency / Q000097:blood* / Q000150:complications*; D012307:Risk Factors
D008055:Lipids; D017270:Lipoprotein(a); D003404:Creatinine