Some biochemical aspects associated with accelerated atherosclerosis in chronic renal failure

ABSTRACT

This study included fifteen patients diagnosed as chronic non-nephrotic renal failure to whom dialysis had never been done and thirty patients diagnosed as chronic non-nephrotic renal failure who were under maintenance hemodialysis for at least one year. In addition a control group of 10 healthy subjects of matched age, sex and socioeconomic status was included in the study. To all subjects the following was done serum Lp[a], apolipoprotein-B, Thiobarbituric acid reactive substances [TBARS] and lipid profile. Serum Lp[a] was found to be higher in both chronic renal failure groups, either dialyzed or un-dialyzed, when compared to controls. TBARS levels were significantly elevated in both dialyzed and undialyzed group of patients than the control group. The prevalence of cardiovascular diseases was 20% in the non-dialyzed group of patients and 40% in the dialyzed group in-spite of the normal or subnormal serum total cholesterol. This point out to the possibility that other lipoprotein abnormalities such as the increased Lp[a] and increased lipid peroxidation are probably incriminated in the prevalence of accelerated atherosclerosis. It could be concluded that Lp[a] is an independent risk factor for atherosclerosis in chronic renal failure patients. This risk increases with the process of hemodialysis. Increased lipid peroxidation in these patients is an additional factor for the accelerated atherosclerosis