Lipoprotein(a)-associated atherothrombotic risk in hemodialysis patients

Enzo Emanuele, Luigi Segagni Lusignani, Emmanouil Peros, Giovanni Montagna, Angela D'Angelo, Lorenza Montagna, Diego Geroldi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Hemodialysis patients show a considerably higher risk of atherothrombotic disease than the general population. We investigated both lipoprotein(a) [Lp(a)] plasma levels and apolipoprotein(a) [apo(a)] phenotypes in relation to occurrence of atherothrombotic events in hemodialysis patients compared with subjects showing a normal kidney function. Methods: Lp(a) levels and apo(a) isoforms were determined in 118 hemodialysis patients, including 59 with prior atherothrombotic events, and in 182 subjects with normal creatinine clearance, including 82 who experienced a prior atherothrombotic event. Results: Lp(a) levels in hemodialysis patients (median; 20 mg/dl) were higher (p <0.01) than in age- and sex-matched subjects with normal renal function without a history of atherothrombosis (11.3 mg/dl). Among hemodialysis patients, median Lp(a) levels were higher in subjects with than in those without prior atherothrombosis (34 vs. 15 mg/dl, p <0.05). In hemodialysis patients and in subjects without nephropathy, the percentage of low-molecular-weight apo(a) phenotypes were significantly higher in patients with than in those without a history of prior atherothrombotic events (56.9% vs. 33.9%, p <0.05; 62.2% vs. 25%, p <0.00001, respectively). Stepwise regression analysis indicated that the presence of at least one apo(a) isoform of low molecular weight was an independent predictor of atherothrombosis in hemodialysis patients (p <0.05). Conclusions: Elevated Lp(a) plasma levels appear to be associated with atherothrombosis, independent of their origin due to genetic factors or related to the impaired kidney function. Low-molecular-weight apo(a) isoforms are reliable genetic markers of atherothrombosis both in patients with impaired kidney function and in subjects without nephropathy.

Original languageEnglish
Pages (from-to)221-229
Number of pages9
JournalAmerican Journal of Nephrology
Volume24
Issue number2
DOIs
Publication statusPublished - 2004

Keywords

  • Apolipoprotein(a) isoforms
  • Atherothrombosis
  • Hemodialysis
  • Lipoprotein(a)
  • Renal function

ASJC Scopus subject areas

  • Nephrology

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