SYMPTOMATIC ANTIPROTEINURIC TREATMENT DECREASES SERUM-LIPOPROTEIN (A) CONCENTRATION IN PATIENTS WITH GLOMERULAR PROTEINURIA

RT GANSEVOORT, JE HEEG, FD DIKKESCHEI, D DEZEEUW, PE DEJONG, RPF DULLAART

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Abstract

Elevated serum levels of the atherogenic and thrombogenic lipoprotein (a) (Lp(a)) have been recognized as a feature of the nephrotic syndrome associated hyperlipidaemia. To examine a possible relationship between serum Lp(a) concentration and proteinuria, serum albumin, or blood pressure, we studied nine patients with nephrotic-range proteinuria both at baseline and after various forms of antihypertensive and antiproteinuric treatment. In fixed order, patients received conventional antihypertensive treatment (either alpha-methyldopa or clonidine), subsequently ACE-inhibition therapy (lisinopril), ACE inhibition combined with an NSAID (indomethacin), and finally NSAID plus conventional antihypertensive therapy. Measurements were performed at the end of each 2-month study period.

When compared to controls (n=29), proteinuric patients before treatment showed increased levels of total cholesterol, very-low and low-density lipoprotein (VLDL+LDL) cholesterol, triglycerides and apolipoprotein B (apoB), while high-density lipoprotein (HDL) HDL cholesterol was lower. Lp(a) was significantly higher in patients (107 (95% CI: 55-208) mg/l) as compared to controls (25 (13-49) mg/l, P

In conclusion, effective symptomatic antiproteinuric treatment decreases serum Lp(a) levels in patients with glomerular proteinuria. Our data suggests that renal protein leakage plays a more important role in the metabolic regulation of this lipoprotein than serum albumin level, and that antiproteinuric treatment may be of benefit in reducing the increased risk of thrombosis and atherosclerosis observed in this patient category.

Original languageEnglish
Pages (from-to)244-250
Number of pages7
JournalNephrology Dialysis Transplantation
Volume9
Issue number3
Publication statusPublished - 1994

Keywords

  • ACE INHIBITION
  • ALBUMIN
  • NEPHROTIC SYNDROME
  • PROTEINURIA
  • LIPOPROTEIN (A)
  • NONSTEROIDAL ANTIINFLAMMATORY DRUGS
  • CORONARY HEART-DISEASE
  • NEPHROTIC SYNDROME
  • DENSITY-LIPOPROTEIN
  • LP(A) LIPOPROTEIN
  • PLASMA LIPOPROTEIN(A)
  • APOLIPOPROTEIN-B
  • INHIBITOR
  • ATHEROSCLEROSIS
  • HYPERLIPIDEMIA
  • THROMBOGENESIS

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