Bostom AG, Shemin D, Lapane K, Sutherland P, Nadeau M, Wilson
PWF, et al.
Concordant elevations in plasma homocysteine, fibrinogen, and
lipoprotein(a) in dialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1474 1996
The prevalence of three non-traditional risk factors for atherosclerosis,
namely
hyperhomocysteinemia, hyperfibrinogenemia and lipoprotein (a) excess were
measured in 71 dialysis
patients and 71 age, gender and race matched Framingham study controls free
of clinical renal
disease (serum creatinine < 1.5 mg/dl).
Higher levels of tHcy (geometric mean 22.7 vs 9.1 uM), fibrinogen (geometric
mean 437 vs 305 mg/dl)
and Lp(a) (square root mean 25 vs 12 mg/dl) were found in dialysis patients
compared to matched
controls, after controlling for prevalent cardiovascular disease, glucose
intolerance, total/HDL
cholesterol ratio, hypertension and smoking.
Comment: These three non-traditional measures of atherosclerosis may
explain the high
incidence of vascular disease in ESRD patients which remains unexplained by
traditional vascular
disease risk factors such as smoking and cholesterol levels.
(Michael V. Rocco, M.D., Bowman Gray School of Medicine)
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Am Soc Nephrol
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