Hyperhomocysteinemia, hyperfibrinogenemia, and lipoprotein (a) excess in maintenance dialysis patients: a matched case-control study.

摘要: Abstract Maintenance dialysis patients experience an exceedingly high incidence of arteriosclerotic cardiovascular disease (CVD) events that are poorly predicted by traditional CVD risk factor indices. We evaluated the prevalence three non-traditional factors, i.e. hyperhomocysteinemia, hyperfibrinogenemia, and lipoprotein (a) (Lp(a)) excess, combined Lp(a) in maintenance patients. Fasting total plasma homocysteine (Hcy), fibrinogen, Lp(a), glucose, HDL cholesterol levels, (i.e. glucose tolerance, smoking, hypertension, dyslipidemia) prevalences were assessed 71 age, sex, race matched Framingham Study controls free clinical renal disease, with normal serum creatinine (≤ 1.5 mg/dl). Mean Hcy (23.7 vs. 9.9 μM, P = 0.0001), fibrinogen (457 309 mg/dl, (30 17 0.0070) levels substantially increased Matched odds ratios (with 95% confidence intervals), patients/controls, for alone or combined, markedly greater patients, no evidence confounding factors: 105.0 (29.9–368.9); 16.6 (6.6–42.0); 3.5 (1.5–8.4); all 35.0 (5.7–199.8). Given vitro Hcy, interact to promote atherothrombosis, excess may contribute vascular sequelae experienced which is inadequately explained factors. Controlled, prospective studies well-characterized cohorts urgently required substantiate this hypothesis.