Plasma Levels of Coronary Risk Biomarkers in Chronic Kidney Disease Patients Undergoing Maintenance Hemodialysis

Objective: Coronary heart disease (CAD) is the commonest complication in patients with chronic kidney disease (CKD) under hemodialysis (HD). Coronary risk biomarkers, namely, plasma levels of lipids, apo(lipo)proteins, oxidized (ox)-lowdensity lipoprotein (LDL), and adiponectin were compared between HD patients and age, sex, and body mass index-matched controls. Methods and results: Eighty HD patients and 80 controls were enrolled. Plasma levels of apoproteins were measured with a turbidimetric immunoassay. Ox-LDL and adiponectin were measured by an enzyme-linked immunoassay. Plasma levels of LDLcholesterol (C), high-density lipoprotein (HDL)-C, apoprotein (apo) B, apo A1, and ox-LDL were lower in HD patients than controls (p < 0.0001). Ratios of LDL-C/ox-LDL were higher in HD subjects than in controls (p < 0.0001). Plasma levels of remnantlike lipoprotein particle cholesterol that is equivalent to triglyceride-rich lipoprotein remnant were higher in HD patients (p < 0.0001). Plasma levels of adiponectin were higher and the abdominal circumference/adiponectin ratio was lower in HD patients than in controls (p < 0.0001). Conclusion: Plasma levels of LDL-C, ox-LDL, and adiponectin should not be used as coronary risk biomarkers in HD patients. However, high levels of remnant-like lipoprotein particle cholesterol represent a significant coronary risk in HD patients.