Close Relationship of Serum Lipoprotein(A) with Ultrasonographically Determined Early Atherosclerotic Changes in The Carotid and Femoral Arteries in End-Stage Renal Failure Patients Undergoing Hemodialysis

Lp(a) is recognized as an independent risk factor for premature atherosclerotic coronary heart disease. In renal failure, studies revealed an increase in plasma concentration of Lp(a), present study aimed to evaluate the effects of plasma Lp(a) levels on early structural atherosclerotic vascular changes in a group of end-stage renal failure patients under regular hemodialysis.
Sixty one unselected patients with end-stage renal disease (ESRD), undergoing maintenance hemodialysis treatment between September 2002 and December 2003 were examined, serum lipoprotein(a) was measured, using B-mode ultrasonography carotid-intimae-media thickness (IMT) measured as well as carotid-femoral plaques (plaque score) were determined.
Total patients (23 females, 38 males) consist 50 non-diabetic hemodialysis patients (20 females, 30 males), and 11 diabetic hemodialysis patients (3 females, 8 males). Mean±SD of Lp(a) of total patients were 58.5±19 mg/dl, for diabetic group were 62±12.3 mg/dl and for non-diabetic group were 57.7±20 mg/dl. In this study there were, more thickening of intimae-media complex in diabetic group, positive association of plaque score with ages and DM, positive correlation of carotid-IMT with carotid-femoral plaque score, positive correlation of serum Lp(a) with carotid-IMT and carotid-femoral plaque score. No significant difference of Lp(a) between diabetic and non-diabetic HD patients was found.
Diabetic hemodialysis patients had more accelerated atherosclerosis, lipoprotein(a) as a non-traditional factor in progression of atherosclerosis, can have a role in acceleration of rapid progressive atherosclerosis seen in these patients.