Lipoprotein(a) in nephrotic syndrome.

ABSTRACT

Serum lipoprotein(a) levels were measured in 27 patients with idiopathic nephrotic syndrome (NS), 14 patients with systemic lupus erythematosus (SLE) and 30 healthy controls. Lp(a) levels were significantly elevated in both idiopathic NS (53.4 + 36.2) and SLE (49.3+ 41.9) compared with controls (9.5+ 5.7) (p < 0.001). Fifty nine percent of idiopathic NS and 50 percent of SLE had Lp(a) more than 30 mg/dl. In 19 patients with idiopathic NS, serum Lp(a) levels fell markedly in 12 patients who responded to prednisolone therapy while, 7 patients with partial and no response had serum Lp(a), cholesterol, triglycerides and albumin levels not different from pretreatment period vs 6 months therapy. Lp(a) levels correlated significantly with proteinuria, serum cholesterol and triglycerides (r = 0.8, 0.6, 0.6) in idiopathic nephrotic syndrome and correlated inversely with serum albumin (r = -0.9). The SLE patients had the same pattern of correlation among these parameters and Lp(a) levels except for triglycerides. The high levels of Lp(a) in the NS could be one of the risk factors for atherosclerosis and thrombotic events associated with this disorder. In conclusion, the present study confirmed that patients with idiopathic NS and SLE had markedly increased serum level of Lp(a), in conjunction with other lipid abnormalities. The serum Lp(a) levels decreased substantially in all NS patients who experienced remission. In addition, the study also demonstrated a relationship between serum Lp(a) levels and serum albumin, cholesterol and triglycerides. An elevated Lp(a) level may be useful in guiding the physician towards more aggressive care to detect coronary artery disease early in patients at risk.