[Lipoprotein (a) is a risk factor for cerebrovascular accident in patients with chronic renal failure].

Cerebrovascular accident (CVA) is an important predictor of survival in patients with chronic renal failure (CRF). Although serum lipoprotein (a) [Lp(a)] is an independent risk factor for atherosclerosis in the general population and Lp(a) levels are increased in patients with CRF, the relationship between increased Lp(a) and CVA has not been clarified in patients with CRF. We therefore determined the association between serum Lp(a) levels and the risk of CVA in a retrospective study of 105 patients with CRF. Lp(a) was measured by ELISA in 31 patients with CVA and 74 patients without CVA. The median Lp(a) concentration of the patients with CVA was significantly higher than that of patients without CVA (38 vs 23 mg/dl: p < 0.001). Logistic regression analysis determined that elevated serum Lp(a) concentration (relative risk ratio: 1.041, p < 0.005), hypertension (relative risk ratio: 9.747, p < 0.05) and smoking (relative risk ratio: 4.554, p < 0.05) were risk factors for CVA. In contrast, serum total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, gender underlying condition of renal disease and duration of hemodialysis were not associated with an increased risk of CVA. These results suggest that Lp(a) is a risk factor for clinical events attributable to CVA in patients with CRF.