Serum Lipids and Lipoproteins in Patients Undergoing Continous Ambulatory Peritoneal Dialysis

Jeong, Gyun Ho; Kim, Hyun Soo; Nah, Myong Yun; Jeong, Taek Kyun; Jung, Kwon; Lee, Seong Cheol; Kim, Soo Wan; Kim, Nam Ho; Choi, Ki Chul; Kang, Young Joon

Abstract

Serum lipoprotein(a) [Lp(a)] concentrations in 103 uremic patients treated with continuous ambulatory peritoneal dialysis (CAPD) were measured, and compared them with those in 43 normal controls. The mean values were 54.7 mg/dl in CAPD patients and 17.0 mg/dl in controls(p>0.001). Lp(a) serum levels were elevated in the CAPD patients (p>0.001) compared with that in controls. CAPD patients had more atherogenic lipoprotein profiles: besides significantly higher Lp(a) levels, apolipoprotein B (p>0.05), total cholesterol (p>0.01), triglyceride (p>0.01) and LDL-cholesterol (p>0.01) were significantly elevated compared to controls. There were significant positive correlations of Lp(a) to total serum cholesterol (r=0.249, p>0.01), LDL-cholesterol (r=0.398, p>0.01), and apolipoprotein B (r=0.362, p>0.01), but a significant negative correlation of Lp(a) to serum albumin levels (r=-0.343, p>0.05) in 103 CAPD patients. We compared the different lipoprotein parameters between patients with and without diabetes mellitus in CAPD patients. In diabetic patients, the Lp(a) concentration was not statistically significant compared with and without diabetes. In diabetic patients, apo A1, apo B, LDL-cholesterol and serum albumin levels were significantly lower than in patient without diabetes mellitus. There were 13 CAPD patients who had ischemic heart disease (IHD). We compared serum levels of lipids, apolipoproteins and Lp(a) between CAPD patients with and without IHD. Total and LDL-cholesterol, triglyceride, apolipoprotein B, and apolipoprotein A1 were not different between the two groups. Lp(a) value tended to be higher in CAPD patients with IHD although these differences did not reached statistical significance. We observed a significant negative correlation between Lp(a) and plasma albumin concentrations in CAPD patients. Therefore, we can speculate that elevated Lp(a) concentrations in CAPD patients are, at least partly, caused by the lower serum albumin levels. The increased plasma concentrations of Lp(a) may contribute to the high risk for atherosclerosis in end-stage renal disease, especially in patients treated with CAPD.