Lipoprotein (a) in patients on maintenance haemodialysis and continuous ambulatory peritoneal dialysis.

Lipoprotein (a) concentrations and apoprotein (a) isoforms were measured in 99 haemodialysis and 79 peritoneal dialysis patients and compared with a normal population. Peritoneal dialysis patients demonstrated a threefold and haemodialysis a twofold increase in median Lp(a) values compared to controls (P < or = 0.001). The peritoneal dialysis group had significantly more patients with Lp(a) values greater than 30 mg/dl compared to controls, (53% versus 22% P < or = 0.001). In addition both patient groups demonstrated significant hypertriglyceridaemia (P < or = 0.001), reduction in HDL (P < or = 0.001) and elevation of the cholesterol/HDL ratio (P < or = 0.001) compared with controls. Peritoneal dialysis patients also demonstrated significant hypercholesterolaemia (P < or = 0.003). Lipoprotein (a) concentrations are considerably elevated in patients on maintenance dialysis and this occurs in addition to the typical lipoprotein disturbances. This elevation may increase vascular risk, particularly in the peritoneal dialysis group who also have hypercholesterolaemia and reduced HDL.