title: Apolipoprotein(a) phenotypes and lipoprotein(a) concentrations in patients with renal failure.
abstract: Patients with renal failure have an increased incidence of atherosclerotic disease. Numerous studies have shown that these patients show increased serum lipoprotein(a) [Lp(a)] concentrations compared with the control population. However, variable alleles at the apolipoprotein(a) [apo(a)] gene locus determine to a large extent the Lp(a) concentration in the general population. We therefore undertook the present study to evaluate apo(a) phenotypes and Lp(a) serum concentrations in a large number of patients with renal disease. Seventy-nine patients treated by hemodialysis (HD), 47 patients treated by continuous ambulatory peritoneal dialysis (CAPD), 68 patients with mild/moderate chronic renal failure (CRF) and serum creatinine levels of 1.8 to 8 mg/dL, and 73 healthy controls were studied. All patients showed significantly elevated median serum Lp(a) concentrations in comparison with controls: HD patients, 15.7 mg/dL (P < 0.01); CAPD patients, 20 mg/dL (P < 0. 005); CRF patients, 15.1 mg/dL (P < 0.01) versus controls, 7 mg/dL. The greater Lp(a) values in all groups were not explained by differences in isoform frequencies, whereas their increase was apo(a)-type specific. Thus, patients in all groups with high-molecular-weight (HMW) apo(a) isoforms showed a significant elevation of Lp(a) levels, whereas serum Lp(a) concentrations in patients with low-molecular-weight (LMW) isoforms were not significantly different from controls, except for CAPD patients, who presented increased serum Lp(a) concentrations. We conclude that in patients with renal failure, even of mild/moderate degree, as well as in patients with end-stage renal disease undergoing HD or CAPD, elevated Lp(a) concentrations are mainly observed in those with HMW apo(a) phenotypes.
authors.affiliation: Laboratory of Biochemistry, University of Ioannina, Greece.
authors.forename: H J
authors.initials: HJ
authors.lastname: Milionis
authors.forename: M S
authors.initials: MS
authors.lastname: Elisaf
authors.forename: A
authors.initials: A
authors.lastname: Tselepis
authors.forename: E
authors.initials: E
authors.lastname: Bairaktari
authors.forename: S A
authors.initials: SA
authors.lastname: Karabina
authors.forename: K C
authors.initials: KC
authors.lastname: Siamopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001054:Apolipoproteins A / Q000235:genetics*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood*; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010641:Phenotype; D006435:Renal Dialysis
chemical_list: D001054:Apolipoproteins A; D017270:Lipoprotein(a)