RESUMEN
BACKGROUND: Studies have shown that patients with chronic renal failure have a high frequency of cardiovascular atheromatous disease. METHODS: We examined serum lipoprotein (a) [Lp(a)], very-low density lipoprotein cholesterol (VLDL-C), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (apo A1) and B (apo B), triglyceride (TG) and total cholesterol (TC) levels as possible risk factors for atherosclerosis in 45 patients with chronic renal failure (CRF) treated by hemodialysis (HD) and in 15 CRF patients who were not on HD. A control group of 20 healthy subjects was also studied. RESULTS: The proportion of smokers and body mass indexes were similar between the groups. In both patient groups, higher TG, TC and Lp(a) and lower apo A1 and HDL-C levels in serum were found than in those of controls. Serum apo B and LDL-C were similar in the patients treated by HD and the controls. Serum VLDL-C and LDL-C were similar in the CRF patients who were not on HD and the controls. The highest ratios of apo B/apo A1 and LDL-C/HDL-C were found in HD patients. The highest ratio of TC/HDL-C was found in the other patient group. We found significant correlations between Lp(a) and other parameters of lipoprotein metabolism in CRF patients, both those who were and those who were not on HD. CONCLUSIONS: Our results indicate that CRF patients who both were and were not on HD show atherogenic changes in the lipoprotein pattern, and that the increase in Lp(a) during the CRF phase is basically related to the loss of renal function and may also depend on the resultant alterations which are produced in other lipoprotein variables.
