Close relationship of serum lipoprotein A with ultrasonographically determined early atherosclerotic changes in the carotid and femoral arteries in end - stage renal failure patients undergoing hemodialysis

ABSTRACT

Lp[a] is recognized as an independent risk factor for premature atherosclerotic coronary heart disease. In renal failure, studies revealed an increase in plasma concentration of Lp[a], present study aimed to evaluate the effects of plasma Lp[a] levels on early structural atherosclerotic vascular changes in a group of end-stage renal failure patients under regular hemodialysis. Sixty one unselected patients with end-stage renal disease [ESRD], undergoing maintenance hemodialysis treatment between September 2002 and December 2003 were examined, serum lipoprotein[a] was measured, using B-mode ultrasonography carotid-intimae-media thickness [IMT] measured as well as carotid-femoral plaques [plaque score] were determined. Total patients [23 females, 38 males] consist 50 non-diabetic hemodialysis patients [20 females, 30 males], and 11 diabetic hemodialysis patients [3 females, 8 males]. Mean +/- SD of Lp[a] of total patients were 58.5 +/- 19 mg/dl, for diabetic group were 62 +/- 12.3 mg/dl and for non-diabetic group were 57.7 +/- 20 mg/dl. In this study there were, more thickening of intimae-media complex in diabetic group, positive association of plaque score with ages and DM, positive correlation of carotid-IMT with carotid-femoral plaque score, positive correlation of serum Lp[a] with carotid-IMT and carotid-femoral plaque score. No significant difference of Lp[a] between diabetic and non-diabetic HD patients was found. Diabetic hemodialysis patients had more accelerated atherosclerosis, lipoprotein[a] as a non-traditional factor in progression of atherosclerosis, can have a role in acceleration of rapid progressive atherosclerosis seen in these patients