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Nephrol Dial Transplant (1992) 7: 597-601
© 1992 European Renal Association-European Dialysis and Transplant Association

research-article

Lipoprotein (a) in patients with proteinuria

M. E. Thomas, A. Freestone, Z. Varghese, J. W. Persaud and J. F. Moorhead

Department of Nephrology and Transplantation, The Royal Free Hospital London, UK

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr Mark E. Thomas, Renal Division, Washington University School of Medicine, Box 8126, 660 South Euclid Avenue, St Louis, MO 63110, USA.

Lipoprotein(a) (Lp(a)) has recently been recognized to be a risk factor for coronary heart disease. Lp(a) median values in the absence of renal disease are around 10 mg/dl. Higher levels (≥ 30 mg/dl) correlate with the occurrence of coronary heart disease, particularly in the presence of elevated cholesterol. We have studied Lp(a) in 76 adults with proteinuria. Fifty had glomerular diseases and 26 non-glomerular diseases, with renal function varying from normal to advanced chronic renal failure. Lp(a) values were shifted to the right, with a median of 21.0 mg/dl, and 25% of patients had values of 30 mg/dl or more. Lp(a) did not correlate with cholesterol, age, lipoprotein subclasses, apoproteins A-I or B-100, albumin, creatinine, or creatinine clearance. Median Lp(a) values did not differ significantly comparing men versus women, or glomerular versus non-glomerular disease. Lp(a) may inhibit fibrinolysis, and is deposited in atherosclerotic lesions. Although the cause of these elevated Lp(a) levels is uncertain, we propose that they contribute to the increased risk of coronary heart disease in the nephrotic syndrome, and may play a role in progressive renal disease

Keywords: coronary heart disease; lipoprotein(a); nephrotic syndrome; proteinuria


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