The relationship of lipoprotein(a) and apolipoprotein(a) isomorphs in renal failure patients on hemodialysis and peritoneal dialysis

Abstract Background: The relationship of lipoprotein (a) [Lp(a)] concentrations with risk of coronary heart disease needs clarification, especially for threshold values for increased risk and for possible interactions with LDL-cholesterol concentrations and apolipoprotein (a) [apo(a)] size polymorphism. This study was designed to examine the ability of baseline Lp(a) concentration and apo(a) size to predict future severe angina pectoris in apparently healthy men. Methods: Baseline Lp(a) concentration and apo(a) size were determined in 195 men who subsequently developed angina and in 195 men who remained free of cardiovascular disease for 5 years. Results: Cases had higher median Lp(a) concentrations than did controls (30.6 vs 22.5 nmol/L; P = 0.02). Lp(a) concentration was predictive of angina [relative risk (RR) from lowest to highest quintiles: 1.0, 1.5, 1.0, 1.8, and 2.6; P for trend = 0.015]. The increased risk was ∼4-fold (95% confidence interval, 1.4- to 11-fold) among men who had Lp(a) above the 95th percentile (>158 nmol/L). Men with Lp(a) concentrations in the highest quintile and LDL-cholesterol concentrations >1600 mg/L had a 12-fold increased risk (95% confidence interval, 1.5- to 43-fold). Small apo(a) size isoforms also significantly predicted risk of angina (RR for lowest quintile = 4.1; P for trend = 0.004). When the independent effect of Lp(a) concentration and apo(a) size was assessed by including them in the same multivariate model, only the association between apo(a) size and risk remained significant. Conclusions: High Lp(a) predicts risk of angina, and the risk is substantially increased with high concomitant LDL-cholesterol. Small apo(a) size predicts angina with greater strength and independence than Lp(a) concentration.

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Continuous ambulatory peritoneal dialysis in diabetic patients. The relationship of hypertension to retinopathy and cardiovascular complications.

Hypertension ◽

10.1161/01.hyp.7.6_pt_2.ii125 ◽

1985 ◽

Vol 7 (6_pt_2) ◽

Author(s):

J Rottembourg ◽

M Remaoun ◽

K Maiga ◽

P Bellio ◽

B Issad ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Cardiovascular Complications ◽

Diabetic Patients ◽

Relationship Of ◽

The Relationship

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Relationship of lipoprotein(a) molar concentrations and mass according to lipoprotein(a) thresholds and apolipoprotein(a) isoform size

Journal of Clinical Lipidology ◽

10.1016/j.jacl.2018.07.003 ◽

2018 ◽

Vol 12 (5) ◽

pp. 1313-1323 ◽

Cited By ~ 19

Author(s):

Sotirios Tsimikas ◽

Sergio Fazio ◽

Nicholas J. Viney ◽

Shuting Xia ◽

Joseph L. Witztum ◽

...

Keyword(s):

Lipoprotein A ◽

Apolipoprotein A ◽

Relationship Of

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The relationship of hypertension and renal failure in scleroderma (progressive systemic sclerosis) to structural and functional abnormalities of the renal cortical circulation

Classic Papers in Rheumatology ◽

10.3109/9780203214237-94 ◽

2001 ◽

pp. 192-193

Keyword(s):

Renal Failure ◽

Systemic Sclerosis ◽

Progressive Systemic Sclerosis ◽

Relationship Of ◽

The Relationship

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Relationship of Adherent Bacterial Biofilms to Peritonitis in Chronic Ambulatory Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686088700700310 ◽

1987 ◽

Vol 7 (3) ◽

pp. 168-173 ◽

Cited By ~ 41

Author(s):

Mrinal K. Oasgupta ◽

Kelvin B. Bettcher ◽

Raymond A. Ulan ◽

Valorie Burns ◽

Kan Lam ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Study Groups ◽

Bacterial Biofilms ◽

Control Group ◽

Bacterial Cultures ◽

Successful Transplantation ◽

Catheter Surface ◽

Relationship Of ◽

The Relationship ◽

Chronic Ambulatory Peritoneal Dialysis

To examine the relationship of the formation of biofilm (adherent bacterial microcolonies) to recurrent peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPO) we examined the surfaces of 25 recovered Tenckhoff (T) catheters by scanning electron microscopy (SEM) and microbiological examination of scrapings. Twelve catheters had been removed after successful transplantation; the patients had not been dialyzed for three months and had no evidence of peritonitis during that period (control group), and only seven had experienced peritonitis (I or 2 episodes) before transplantation. All 13 patients in the study group had experienced repeated episodes of peritonitis (range 3–13, average, 5.6). We detected no significant differences between the control and study groups with respect to the percentage of catheter-surface covered by biofilm, or the proportion of catheter segments whose scrapings yielded positive bacterial cultures. It is concluded that large areas of the T catheters of CAPO patients are colonized by bacterial biofilms but only active dialysis predisposes to recurrent peritonitis.

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Apolipoprotein(a) Phenotype and Lipoprotein(a) Level Predict Peritoneal Dialysis Patient Mortality

Peritoneal Dialysis International ◽

10.1177/089686080202200408 ◽

2002 ◽

Vol 22 (4) ◽

pp. 492-499 ◽

Cited By ~ 14

Author(s):

Eduard A. Iliescu ◽

Santica M. Marcovina ◽

Alexander R. Morton ◽

Miu Lam ◽

Marlys L. Koschinsky

Keyword(s):

Cardiovascular Disease ◽

Peritoneal Dialysis ◽

Tertiary Care ◽

Inverse Correlation ◽

Peritoneal Dialysis Patient ◽

Lipoprotein A ◽

Apolipoprotein A ◽

Size Number ◽

Care Health

♦ Objective To examine the associations between lipoprotein(a) [Lp(a)] level, apolipoprotein(a) [apo(a)] phenotype, and patient mortality in peritoneal dialysis (PD) patients. ♦ Design Observational prospective study of prevalent PD patients. ♦ Setting Tertiary-care health sciences center. ♦ Patients 54 prevalent PD patients were followed prospectively for 24 months. ♦ Main Outcome Measures The exposures were Lp(a) level and apo(a) phenotype, designated by the apo(a) isoform size (number of kringle 4 repeats). Outcome was death from any cause. ♦ Results There were 24 deaths in 77.9 patient–years’ follow-up. The independent predictors of death in the multivariate survival analysis were age [relative risk (RR) = 1.03, p = 0.23], diabetes (RR = 3.00, p = 0.03), diastolic blood pressure ≤ 70 mmHg (RR = 2.94, p = 0.03), serum albumin (RR = 0.87, p < 0.01), and Lp(a) level (RR = 1.004, p < 0.01). There was strong inverse correlation of Lp(a) with apo(a) isoform size ( r = –0.62, p < 0.01). With Lp(a) removed from the model, apo(a) isoform size was a significant predictor of death (RR = 0.91, p = 0.0497). ♦ Conclusions Lipoprotein(a) level and apo(a) phenotype are associated with PD patient mortality. Measurement of Lp(a) level and apo(a) phenotype may be useful in clinical practice to identify patients at high risk for cardiovascular disease. Large prospective studies are needed to determine if a reversal of the increase in Lp(a) level associated with renal disease and dialysis is feasible and beneficial in reducing the risk of cardiovascular disease and mortality.

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