K014: Substantial risk factors for atherothrombotic vascular disease in hemodialysis patients

Hemodialysis (HD) patients (pts) have increased incidence of atherosclerotic cardiovascular complications. In an attempt to determine the significance of several athero- and thrombogenic parameters as risk factors for atherothrombotic disease in these pts, we compared 2 groups of stable HD pts matched for age and sex. Selected according to the absence (Group 1, n:30) or the presence (Group 2, n:30) of symptomatic vascular disease affecting the coronary, cerebral or peripheral arteries. All pts (n:60) were on bicarbonate HD, received low-molecular-weight heparin as anticoagulant and the vast majority (80%) was on erythropoietin treatment. Serum TC, TG, HDL-C, LDL-C, TC/HDL-C ratio, Lp (a), FNG, PNG and FNC were measured predialysis. Hypertension, primary renal disease (PRD), duration of HD and smoking habits were also recorded. (See Table) Parameters Group 1 (n:30) Group 2 (n:30) p TC (mg/dl) 196 ± 31 219 ± 56 NS* TG (mg/dl) 160 ± 55 179 ± 92 NS* HDL-C (mg/dl) 38.5 ± 8.4 39 ± 11 NS* LDL-C (mg/dl) 125 ± 26 144 ± 48 NS* TC/HDL-C 5.2 ± 1.2 6 ± 2.1 NS* Lp(a) (mg/dl) 21.8 ± 22.4 43.1 ± 38.3 0.003** FNG (mg/dl) 318 ± 70 339 ± 91 NS* PNG (mg/dl) 11.6 ± 3.5 11.8 ± 2.9 NS* FNC (mg/dl) 32.2 ± 3.9 35.2 ± 6.7 0.041* Smoking (n (%)) 5 (16.7) 12 (40) NS*** Hypertension (n (%)) 8 (26.7) 18 (60) 0.019*** Total cholesterol (TC), triglycerides (TG), lipoprotein (a) (Lp(a)), fibrinogen (FNG), plasminogen (PNG), fibronectin (FNC). *Student's t-test, **Wilcoxon signed rank test, ***Chi-square test Duration of HD and PRD were not different between the two groups. Moreover, using logistic regression analysis with Lp(a), FNC and hypertension as predictor variables, only hypertension (p = 0.021) and Lp(a) (p = 0.040) were significant. Our findings suggest that hypertension and high levels of Lp(a) are substantial risk factors for atherothrombotic vascular disease in HD patients.