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      Lipoprotein(a)-associated atherothrombotic risk in hemodialysis patients.

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          Abstract

          Hemodialysis patients show a considerably higher risk of atherothrombotic disease than the general population. We investigated both lipoprotein(a) [Lp(a)] plasma levels and apolipoprotein(a) [apo(a)] phenotypes in relation to occurrence of atherothrombotic events in hemodialysis patients compared with subjects showing a normal kidney function.

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          Most cited references14

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          cDNA sequence of human apolipoprotein(a) is homologous to plasminogen.

          Lipoprotein(a) is an LDL-like lipoprotein whose concentration in plasma is correlated with atherosclerosis. The characteristic protein component of lipoprotein(a) is apolipoprotein(a) which is disulphide-linked to apolipoprotein B-100. Sequencing of cloned human apolipoprotein(a) complementary DNA shows that it is very similar to human plasminogen. It contains a serine protease domain and two types of plasminogen-like kringle domains, one of which is present in 37 copies.
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            Advanced atherosclerosis in predialysis patients with chronic renal failure.

            Atherosclerosis is advanced in hemodialysis patients as shown by increased intima-media thickness of carotid arteries (CA-IMT), although it is not established whether the advanced atherosclerosis results from hemodialysis treatment or from chronic renal failure. The purpose of this study was to evaluate the effects of hemodialysis and renal failure on CA-IMT in patients with chronic renal failure. CA-IMT was measured by high-resolution B-mode ultrasonography in 110 patients with chronic renal failure before starting dialysis (CRF group), and compared with CA-IMT of 345 hemodialysis patients (HD group) and 302 healthy control subjects. They were all nondiabetic and the three groups were comparable in age and gender. As compared with the healthy control subjects, the CRF and HD groups had greater CA-IMTs, whereas CA-IMTs of the CRF and HD groups were not statistically different. There was no significant correlation between duration of hemodialysis and CA-IMT in the HD group. Multiple regression analysis in the total subjects indicated that presence of renal failure, but not being treated with hemodialysis, was a significant factor associated with increased CA-IMT independent of age, gender, blood pressure, smoking, high-density lipoprotein (HDL) and non-HDL cholesterol levels. These results demonstrate that thickening of arterial wall is present in patients with chronic renal failure before starting hemodialysis treatment, and support the concept that advanced atherosclerosis in hemodialysis patients is due not to hemodialysis treatment, but to renal failure and/or metabolic abnormalities secondary to renal failure.
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              Identification of 34 apolipoprotein(a) isoforms: differential expression of apolipoprotein(a) alleles between American blacks and whites.

              A total of 34 different apo(a) isoforms was identified in a population sample of 806 American Whites and 701 American Blacks by a high resolution SDS-agarose gel electrophoretic method followed by immunoblotting. Among the 1507 individuals tested, 79% revealed double-banded phenotypes and 21% single-banded phenotypes. The frequencies of the apo(a) isoforms differed between American Blacks and Whites (p < 0.001).
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                Author and article information

                Journal
                Am. J. Nephrol.
                American journal of nephrology
                S. Karger AG
                0250-8095
                0250-8095
                March 16 2004
                : 24
                : 2
                Affiliations
                [1 ] Molecular Medicine Laboratory, IRCCS San Matteo Hospital, University of Pavia, Pavia, Italy.
                Article
                77293
                10.1159/000077293
                15017119
                543ea93b-ed81-4092-b32b-afa240f8322a
                History

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