Lipoprotein-A and carotid intima media thickness as cardiovascular risk factors in patients of chronic kidney disease.

Patients in all stages of chronic kidney disease (CKD) are considered in the "high-risk group" for development of cardiovascular disease (CVD). The study was undertaken in 60 adult patients of chronic renal failure. The patients were divided into three groups: Group I had subjects with CKD (stages 1 and 2); Group II had subjects with CKD (stages 3 and 4) on conservative therapy for 3 months; and Group III had subjects with CKD (stage 5) on regular hemodialysis for at least 3-4 weeks. Carotid sonography was done in all patients at the time of inclusion in the study. The patients in all the groups were then followed for 6 months and the relevant investigations were carried out, initially at the time of presentation, and then at third- and sixth-month interval. The patients were monitored for various renal parameters along with serum lipoprotein-A [Lp (A)]. The value of carotid intima media thickness (CA-IMT) was increased in group II and III as compared to group I. The calcification of carotids was higher in patients of group III. The maximum number of patients having plaques and stenosis in the carotids were seen in group III (50%), followed by group II (20%). Patients in group III had 5-10 times higher levels of Lp (A) as compared to patients in group I. The comparison of Lp (A) levels between group I and group II was also highly statistically significant.