Close Relationship of Serum lipoprotein(a) with Ultrasonograghically Determined Early Atherosclerotic Changes in the Carotid and Femoral Artery in End-Stage Renal Failure Patients undergoing Hemodialysis

Hamid Nasri*, Azar Baradaran**

*Medical Sciences.Hajar Medical, Educational and Therapeutic Center, Section of hemodialysis, Ph:0098 911 2439584, Fax:00983812243715(hosp.), E-mail:hamidnasri @yahoo.com, Box:88155-468, Shahrekord, Iran
**Center of Research and Reference Laboratory of Iran, E-mail:azarbaradaran @yahoo.com Hospital Bu Ali, Damavand st., Box:17115-365, 17117Tehran, Iran

Background: 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 treatment. Patients&Methods: Sixty-one patients with end-stage renal disease (ESRD), who receiving maintenance hemodialysis treatment were considered. Serum lipoprotein(a) was measured using B-mode Ultrasonography carotid - intima-media thickness was measured as well as carotid - femoral plaques (plaque score) were determined. Results: The total patients were 61 (F=23 M=38) consisting of 50 non diabetic hemodialysis patients (F=20 M=30) and 11 diabetic hemodialysis patients (F=3 M=8). Mean±SD of LP(a) of total patients were 58.5±19mg/dl. Mean±SD of LP(a) of diabetic group were 62±12.3mg/dl and for nondiabetic group were 57.7±20mg/dl. In this study there were more thickening of Intima-media complex in diabetic group than nondiabetics and no significant difference of LP(a) between diabetic and non diabetic HD patients was found. Positive correlation of plaque score with ages and DM and positive correlation of carotid-IMT with carotid-femoral plaque score were seen. Significant positive correlation of serum LP(a) with carotid-IMT and carotid-femoral plaque score were observed too. Conclusions: Diabetic hemodialysis patients had more accelerated atherosclerosis. Lipoprotein(a) as a non traditional factor in progression of atherosclerosis can have a more important role to accelerate of rapid progressive atherosclerosis observed in these patients.

Keywords:  intima-media thickness, plaque score, carotid-femoral artery, hemodialysis, diabetes mellitus