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).