title: Oxidized low-density lipoprotein biomarkers in patients with end-stage renal failure: acute effects of hemodialysis.
abstract: OBJECTIVE
  To assess the effect of end-stage renal failure on oxidized low-density lipoprotein (OxLDL) biomarkers and the acute effects of hemodialysis. Oxidized phospholipids (OxPL) on apolipoprotein B-100 (apoB) particles (OxPL/apoB) have been associated with cardiovascular disease and new cardiovascular events. Patients with end-stage renal failure have increased oxidative stress and are at significantly increased risk of cardiovascular disease.
  
  
  RESULTS
  Fifty-two stable patients with end-stage renal failure undergoing chronic hemodialysis were included in the study. Pre and post hemodialysis blood samples were obtained for measurement of OxLDL biomarkers: oxidized phospholipids (OxPL) on apolipoprotein B-100 (apoB) particles (OxPL/apoB) measured by antibody E06, IgG and IgM autoantibody titers to copper-oxidized LDL (Cu-OxLDL) and malondialdehyde (MDA)-LDL, IgG and IgM apolipoprotein B-100-immune complexes (IC/apoB). Traditional laboratory variables as well as C-reactive protein (CRP) and lipoprotein(a) [Lp(a)] were also measured. For the baseline variables, the distribution of OxPL/apoB and Lp(a) were skewed to lower values, and a strong correlation was noted between OxPL/apoB and Lp(a) (r = 0.94, p < 0.0001). No major associations were noted between OxLDL biomarkers and age, gender or dialytic age. There were also no correlations between OxLDL biomarkers and traditional risk factors, CRP, body mass index, serum creatinine, hypertension or intravenous iron therapy. Following dialysis, there as a significant reduction in OxPL/apoB (-7.5%, p = 0.048) and triglyceride levels (-10.8%, p = 0.005). All other OxLDL biomarkers, CRP, total cholesterol, LDL-C, HDL-C and apoB-100 increased significantly (range 6.3-26.9%, p value range 0.005 to <0.0001). Total protein plasma levels increased 8.8% (p = 0.014 compared to predialysis) following dialysis, consistent with a hemoconcentration effect of hemodialysis.
  
  
  CONCLUSIONS
  In end-stage renal failure patients undergoing hemodialysis, a reduction in OxPL/apoB levels was noted, despite the hemoconcentrating and strong pro-oxidant milieu of hemodialysis. Studies in larger populations of end-stage renal failure patients are needed to assess whether these findings predict future clinical outcomes.
authors: Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore, Roma, Italia. maubosso@tin.it
authors: Maurizio
authors: M
authors: Bossola
authors: Luigi
authors: L
authors: Tazza
authors: Esther
authors: E
authors: Merki
authors: Stefania
authors: S
authors: Giungi
authors: Giovanna
authors: G
authors: Luciani
authors: Elizabeth R
authors: ER
authors: Miller
authors: Edward B
authors: EB
authors: Lin
authors: Antonio
authors: A
authors: Tortorelli
authors: Sotirios
authors: S
authors: Tsimikas
mesh_terms: D000368:Aged; D001055:Apolipoproteins B / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D001055:Apolipoproteins B; D015415:Biomarkers; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein