Residual renal function affects lipid profile in patients undergoing continuous ambulatory peritoneal dialysis

Abstract

Objective: To determine whether lipoprotein abnormalities associated with continuous ambulatory peritoneal dialysis (CAPD) are influenced by residual renal function (RRF). Design: Open, nonrandomized prospective and comparative study. Setting: Single university teaching hospital dialysis unit and outpatient clinic. Patients: Twenty adult patients on standard CAPD (1-38 months) were divided into two groups: group A (RRF ≤ 0.8 mL/min, n = 10)and group B (RRF ≤ 1.1 mL/ min, n = 10). Patients in the two groups were matched for age, time on dialysis, body weight, body mass index, serum urea and albumin levels, peritoneal and urinary albumin losses, and peritoneal transport characteristics such as overnight 8-hour peritoneal creatinine and β2-microglobulin clearances and overnight 8-hour effluent glucose concentrations. Results: The degree of uremia in patients with preserved RRF (group B) was obviously lower than in patients with negligible RRF (group A), that is, patients in group B had significantly lower serum creatinine and β2-microglobulin levels and significantly higher weekly KT/V than group A patients. Despite the prevalence of allele 4 of apolipoprotein E genotype in group A patients, their levels of serum total cholesterol, low-density lipoprotein cholesterol, lipoprotein (a) [Lp(a)], apolipoprotein B (ApoB), and apolipoprotein A1 (ApoA1) were significantly lower than those of patients with preserved RRF (group B). The two groups did not differ significantly in the serum levels of triglyceride or high-density lipoprotein cholesterol. Serum concentrations of Lp(a) and ApoA1, as well as ratios of ApoA1 to ApoB, were correlated significantly with RRF (r = 0.63, r = 0.5l, and r = 0.61, respectively). Conclusions: The findings suggest that RRF affects the lipid profile of CAPD patients, especially serum levels of cholesterol-rich lipoproteins.