Elevated Lipoprotein A in CKD patients linked to fatal and non fatal CV events

A new study by Leandro Barbagelata and team showed that lipoprotein(a) (Lp(a)) levels and both fatal and non-fatal cardiovascular events are positively correlated in chronic kidney disease (CKD) patients. The findings of this study were published in the Journal Of Nephrology.

The solitary LDL particle that makes up lipoprotein (a), which is connected to the highly polymorphic apo (a) protein, is produced in the liver. Higher plasma levels of Lp(a) are related to an increased risk of coronary heart disease and calcific aortic valve disease, according to epidemiological and genetic research, which also shows that these conditions may be caused by elevated Lp(a) levels. Both an acquired rise in Lp(a) levels and an increased risk of vascular disease are linked to kidney disease.

High levels of lipoprotein (a) are a standalone risk factor for atherosclerotic cardiovascular illnesses in the general population. Less comprehensive data is, however, available for people with chronic renal disease. This revised systematic analysis of prospective studies has the primary goal of examining the relationship between high Lp(a) levels and cardiovascular events or mortality in CKD patients.

This systematic review followed the PRISMA recommendations. The recent literature was reviewed for randomized clinical trials or prospective observational studies that assessed the relationship between Lp(a) levels and cardiovascular events or mortality in CKD patients.

The key findings of this study were:

1. For this systematic review, 15 studies with 12,260 participants were found and deemed eligible.

2. A randomized clinical trial's 14 prospective cohorts as well as one post-hoc analysis were all examined.

3. Six studies examined people with various stages of CKD, eight studies examined hemodialysis patients, one study examined peritoneal dialysis patients.

4. The median number of follow-up years was 8.6 years.

5. The results revealed that, even after controlling for conventional risk factors, subjects with raised Lp(a) levels had a higher risk of cardiovascular events or death.

Reference: 

Barbagelata, L., Masson, W., Corral, P., Lavalle-Cobo, A., Nogueira, J. P., & Rosa Diez, G. (2023). Relationship between lipoprotein(a) levels, cardiovascular outcomes and death in patients with chronic kidney disease: a systematic review of prospective studies. In Journal of Nephrology. Springer Science and Business Media LLC. https://doi.org/10.1007/s40620-023-01590-3