LIPOPROTEIN ABNORMALITIES IN HYPERTRIGLYCERIDEMIC PATIENTS ON LONG-TERM HAEMODIALYSIS

OBJECTIVES: To analyse by ultracentrifugation in a zonal rotor the plasma lipoproteins in hypertriglyceridaemic patients on long-term haemodialysis. DESIGN: Case-control study. SETTING: Tertiary referred care centre. SUBJECTS: Ten consecutive hypertriglyceridaemic patients on haemodialysis and 12 consecutive healthy controls. MAIN OUTCOME MEASURES: Plasma lipid and lipoprotein cholesterol concentrations, lipoprotein physical properties and compositions, apolipoprotein concentrations. RESULTS: Hypertriglyceridaemia in patients undergoing haemodialysis is characterized by an increased amount of small and slow floating very-low density lipoproteins (VLDL), higher concentrations of intermediate density lipoproteins (IDL) and small and dense low-density lipoprotein (LDL) particles; reduced levels of high-density lipoproteins (HDL), in particular of HDL2. The lipoprotein composition of such patients indicates reduced cholesterol ester and increased triglyceride content. Compared to controls, they have lower levels of plasma apolipoprotein A-I and A-II and higher B, C-II, C-III and E values. CONCLUSIONS: The lipoprotein abnormalities observed in hypertriglyceridaemic patients undergoing haemodialysis have recently been associated with an increased incidence of vascular complications and may in part explain the high incidence of vascular disease reported in these subjects.