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      Phospholipid Transfer Protein in Hemodialysis Patients

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          Introduction: Phospholipid transfer protein (PLTP) is mainly involved in high-density lipoprotein (HDL) metabolism. The role of PLTP in atherogenesis is still controversial. We aimed to investigate PLTP activity in hemodialysis (HD) patients, a population which has an increased risk for the development of atherosclerosis. Methods: PLTP activity and other markers were analyzed in blood samples from 68 HD patients and in a matched group of 68 healthy controls. Results: Serum PLTP activity was nearly doubled in HD patients in comparison to healthy controls (median 43.0 vs. 22.4 pmol/µl/h, p < 0.001). In HD patients, PLTP activity correlated with HDL-C (r = 0.342, p = 0.004), but not with CRP (r = –0.057, p = 0.644) or leukocyte count (r = 0.116, p = 0.345). After a follow-up of 2 years, 26 HD patients had died. Kaplan-Meier analyses showed that low CRP (p = 0.047) but neither high HDL-C (p = 0.071) nor low PLTP activity (p = 0.853) were relevantly related to survival of HD patients. Conclusion: An elevated PLTP activity in HD patients may be considered as a further aspect of uremic dyslipidemia in HD patients. However, PLTP activity was not related to markers of inflammation or to survival of HD patients, even though it correlated with HDL-C. Thus, we conclude that PLTP does not influence the prognostically relevant inflammatory process in HD patients although it does influence the composition of HDL particles.

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          Most cited references 13

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          Clinical epidemiology of cardiovascular disease in chronic renal disease.

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            Accelerated atherosclerosis in prolonged maintenance hemodialysis.

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              Hypocholesterolemia is a significant predictor of death in a cohort of chronic hemodialysis patients.

              Although hypocholesterolemia is common in chronic hemodialysis patients, its effect on survival has not been studied in a large patients population. A cohort of chronic hemodialysis patients (N = 1167) was prospectively followed from January 1991 to January 2001. The survival impact of this cohort, who were divided according to different baseline levels of serum cholesterol, were calculated with the multivariate Cox proportional hazard analysis after adjusting for baseline clinical and laboratory variables. During the study period, 567 (48.6%) patients died. The mean (SD) baseline level of serum cholesterol was 171.0 (40.8) mg/dL and ranged from 76 to 378 mg/dL. The five-year survival rate was highest (0.812) in the subgroup that had a serum cholesterol range of 200 to 219 mg/dL and was lowest (0.608) in the subgroup with serum cholesterol values of or =220 mg/dL. Serum cholesterol was a significant predictor of death with an adjusted hazards ratio (95% confidence interval) was 0.939 (0.891 to 0.989). In a subgroup of patients with serum albumin values > or =4.5 g/dL (N = 128), the adjusted hazards ratio was even greater at 1.370 (1.105 to 1.692). Other than sex, body mass index and serum albumin were significant determinants of baseline levels of serum cholesterol. Hypocholesterolemia was an independent predictor of death in patients on chronic hemodialysis. This impact of hypercholesterolemia on survival was only evident in a subgroup of patients whose serum albumin was more than 4.5 g/dL.

                Author and article information

                Am J Nephrol
                American Journal of Nephrology
                S. Karger AG
                April 2007
                16 February 2007
                : 27
                : 2
                : 138-143
                aDepartment of Medicine III, Martin Luther University, Halle-Wittenberg, bDepartment of Medicine IV, University of the Saarland, Homburg/Saar, and cDepartment of Medicine II, Institute for Medical Biostatistics, Epidemiology and Informatics, and Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg University, Mainz, Germany, and dDepartment of Anatomy and Cell Biology, State University of New York, Downstate Medical Center Brooklyn, New York, N.Y., USA
                99943 Am J Nephrol 2007;27:138–143
                © 2007 S. Karger AG, Basel

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                Page count
                Figures: 2, Tables: 2, References: 29, Pages: 6
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/99943
                Original Report: Patient-Oriented, Translational Research


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