Lipoprotein(a) as a risk factor for coronary artery disease in hemodialysis patients

Abstract

Background. We studied whether lipoprotein(a) [Lp(a)] is an independent risk factor for coronary artery disease (CAD) in hemodialysis (HD) patients. Methods. A serum concentration of Lp(a) was measured in 212 patients with chronic glomerulonephritis and 56 patients with diabetic nephropathy (a total of 268 patients). The causes of death during five years of follow-up were studied and classified into either cardiovascular or noncardiovascular events. Results. The mortality of these 268 HD patients during the observation period was 26.1%. Seventy-eight percent were due to cardiovascular events. Those who died of cardiovascular events had significantly higher serum Lp(a) levels than those died of noncardiovascular events. The relative risk of death from CAD was 0.71 in HD patients with a Lp(a) concentration above 30 mg/dl. Conclusions. This study indicates that the serum Lp(a) levels are independent indicators of the future risk of death from CAD in HD patients. © 1999 by the International Society of Nephrology.