ABSTRACT
OBJECTIVE: To establish the prevalence of lipid and lipoprotein (a) abnormalities in patients under hemodialysis or who underwent renal transplantation. METHODS: Forty dialyzed patients, 64 transplanted and a comparison group of 77 subjects of the general population paired by gender and age were studied. RESULTS: The most prevalent disorder in the hemodialysis was hypoalfalipoproteinemia followed by Lp(a) excess while the least common disorder was hypercholesterolemia. The transplanted patients had the lowest prevalence of Lp(a) excess and a higher proportion of hypercholesterolemia when compared to hemodialysis patients but similar to that of controls. CONCLUSION: Our results confirmed some previous findings observations of others but differed in that hypoalfalipoproteinemia and not hypertriglyceridemia was the predominant abnormality in the hemodialysis patients.
Subject(s)
Kidney Failure, Chronic/blood , Kidney Transplantation , Lipids/blood , Lipoprotein(a)/blood , Renal Dialysis , Adult , Analysis of Variance , Case-Control Studies , Female , Humans , Kidney Failure, Chronic/therapy , MaleABSTRACT
Familial hypercholesterolemia (FH) is the genetic lipid disorder with a higher risk to develop coronary heart disease (CHD). In the heterozygous patients there are, however, variability in the atherosclerosis age of onset and severity. In recent years, it has been reported elevated levels of Lp(a) in FH, and it is proposed that this lipoprotein contributes to the development of CHD in these patients. This study evaluates the relationship between Lp(a) levels and the presence of CHD in FH. We included 38 patients with heterozygous FH with or without CHD (13 and 25 respectively), and a control group. In comparison to the control group, FH patients had significant elevated levels of Lp(a) (median 8.1 vs 16 mg/dL), and a greater prevalence of hyper Lp(a) (with a cut-off level of 30 mg/dL) (11.4 vs 25.7%). FH patients with CHD had higher levels of Lp(a) than those without CHD (22.8 vs 14.4 mg/dL). A significative negative correlation between age of onset of CHD and Lp(a) levels was found in females. CHD in FH was associated with male gender, older age, higher prevalence of hypertension, higher waist/hip ratios, higher levels of triglycerides and prevalence of hypertriglyceridemia. Our findings suggest that Lp(a) may play a role as an additional risk factor to develop atherosclerosis in FH.
Subject(s)
Heterozygote , Hyperlipoproteinemia Type II/blood , Lipoprotein(a)/blood , Adult , Age Factors , Analysis of Variance , Chi-Square Distribution , Coronary Artery Disease/blood , Coronary Artery Disease/diagnosis , Coronary Artery Disease/epidemiology , Female , Humans , Hyperlipoproteinemia Type II/diagnosis , Hyperlipoproteinemia Type II/epidemiology , Male , Middle Aged , Regression Analysis , Sex FactorsABSTRACT
During the period of May 1986 through February 1991, nine allogeneic bone marrow transplants (BMT) on eight severe aplastic anemia (SAA) patients were performed at the Instituto Nacional de la Nutrición Salvador Zubirán in Mexico City. Mean age at BMT was 18 years (age interval 12-30); seven were men; all patients had a clinical history of multiple blood transfusions; six individuals were infected at the time of the transplant. The conditioning regimens were: cyclophosphamide (Cy) in three patients; Cy+ total nodal radiation in five; and total nodal radiation only in the second transplant of one patient. Graft versus host disease (GVHD) prophylaxis was attempted with methotrexate plus cyclosporin A (CsA) in six patients, methylprednisolone plus CsA in two, and prednisone + CsA in the patient retransplanted. All procedures were carried out under single reverse isolation without gut decontamination. Seven of the nine procedures grafted (two cases died on days +8 and +25 due to infection). In the surviving, the median time for reaching > 1.0 white blood cells x 10(9)/L was 22 days (time interval 11-31); > 0.5 neutrophils x 10(9)/L in 27 days (time interval 15-42) and the same lapse to reach > 50 platelets x 10(9)/L. Length of hospital stay was 42 days (time interval 15-61). Acute GVHD was seen in one of the seven patients surviving the period of bone marrow aplasia (14%). Of six long term survivors (including one patient with a second transplant) chronic GVHD was present in four (67%): chronic GVHD was fatal in one individual but was well controlled in three.(ABSTRACT TRUNCATED AT 250 WORDS)
