Lipoprotein(a) and treatment of chronic renal disease

Objectives. To compare lipoprotein(a) [Lp(a)] and albumin concentrations in patients with chronic renal disease receiving different forms of treatment and to determine, if any, the relationship between these variables. Design. A prospective cross-sectional, case-controlled study. Setting. A tertiary referral nephrology and dialysis unit. Subjects. Forty-four consecutive non-diabetic patients with chronic renal failure treated by renal transplantation (n = 18), haemodialysis (n = 18), continuous ambulatory peritoneal dialysis (CAPD; n = 8), and 30 healthy controls from subjects drawn from University personnel were studied. Interventions. Fasting morning venous blood was analysed for Lp(a), albumin, total cholesterol and glucose concentrations. Main outcome measures. Comparison of plasma levels of these variables between the sub-groups. Results. Concentrations (median; 95% CI) of Lp(a) were significantly (P < 0.05) higher (38.4 mg dl−1; range 15.4–72.0) and of albumin lower (31.6 g l−1; range 28–35.2) in the CAPD group compared with both control subjects and other groups of chronic renal disease patients. Conclusions. The elevated Lp(a) concentrations seen only in association with reduced albumin concentrations in CAPD patients suggest a regulatory role for albumin with albumin losses stimulating production of Lp(a).