Analysis of Lp(a) Phenotype in Patients with end Stage Renal Disease on Hemodialysis / 대한신장학회잡지

ABSTRACT

BACKGROUNDS: Cardiovascular diseases is one of the major causes of death in patients with end stage renal disease(ESRD) receiving hemodialysis. Elevated plasma concentrations of lipoprotein(a)[Lp(a)] have been established as an independent risk factor for atherosclerotic cardiovascular disease. In this study, we investigated the pattern of apolipoprotein(a)[apo(a)] phenotypes in Korean ESRD patients on hemodialysis and evaluated the relationship between Lp(a) concentration and apo(a) phenotype. METHOD: Fasting serum Lp(a) was measured in 100 patients with ESRD undergoing hemodialysis and in 100 age-and gender-matched normal subjects as control. Apo(a) phenotyping was also performed with SDS-PAGE using Phast system in both groups. RESULT: Lp(a) concentrations were significantly elevated in ESRD patients as compared with the controls(19.2mg/dL, 9.8-38.9mg/dL vs. 4.3mg/dL, 1.0-18.8mg/dL)(p<0.05). Ninety eight patients had apo(a) phenotypes of high molecular weight such as S3, S3S4, S3S5, S4, S4S5, and S5. The distribution of apo(a) isoform in the ESRD patients was not different from that of normal controls. With common apo(a) isoforms such as S3, S4 and S5, elevation of Lp(a) level was demonstrated in ESRD patients compared with normal subjects. CONCLUSIONS: Most of Korean ESRD patients on hemodialysis had apo(a) phenotypes of high molecular weight. And elevation of serum Lp(a) in these patients could be due to the nongenetic factors related with renal failure rather than the apo(a) polymorphism.