Kidney Week

Abstract: SA-PO388

Elevated Lipoprotein(a) Levels Are Associated with Endothelial Dysfunction Measured by Vascular Reactivity Index in Patients on Chronic Hemodialysis

Session Information

• Hemodialysis and Frequent Dialysis - 2
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Lai, Yu-Hsien, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

Yu-Hsien Lai, MD, PhD

• Chang, Yu Chi, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

Yu Chi Chang, MD

• Hsu, Bang-Gee, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

Bang-Gee Hsu, MD, PhD

Background

Lipoprotein(a)(Lp(a)) accelerates the formation of atherosclerotic plaque by its proatherogenic, prothrombotic, and proinflammatory actions and has a positive correlation with cardiovascular disease. We aimed to evaluate the association between serum Lp(a) levels and endothelial function in patients with maintenance hemodialysis (MHD).

Methods

We enrolled 123 MHD patients, and their blood samples and medical records were obtained. We measured endothelial function as vascular reactivity index (VRI) by a non-invasive digital thermal monitor, and serum Lp(a) concentration was measured by a commercial enzyme-linked immunosorbent assay.

Results

Eighteen (14.6%) MHD patients were classified as having poor vascular reactivity, 51 (41.5%) MHD patients as having intermediate vascular reactivity (1.0 ≤ VRI < 2.0), and 54 (43.9%) MHD patients were classified as having high vascular reactivity (VRI ≥ 2.0). The serum alkaline phosphatase (ALP, p = 0.002) and Lp(a) (p < 0.001) levels significantly increased as VRI decreased. The logarithmic transformation of serum ALP (log-ALP, r = −0.252, p = 0.005) and log-Lp(a) (r = −0.578, p < 0.001) was negatively associated with the VRI values by univariate linear regression analysis. Multivariate stepwise linear regression analysis showed a significantly negative association of log-ALP (standardized β = −0.212, adjusted R² change = 0.040; p = 0.001) and log-Lp(a) (standardized β = −0.562, adjusted R² change = 0.328; p < 0.001) with VRI values in MHD patients. Serum Lp(a) was independently associated with vascular reactivity dysfunction (odds ratio (OR) = 1.006; 95% confidence interval (CI) = 1.002–1.009; p = 0.001) and poor vascular reactivity index (OR = 1.009, 95% CI = 1.004–1.014, p < 0.001) in MHD patients by logistic regression analysis.

Conclusion

In this study on MHD patients, along with serum ALP levels, the most significant clinical implication was that serum Lp(a) levels were negatively correlated to the VRI and can be used as a potential novel biomarker of endothelial dysfunction.