Lipoprotein Subfractions, Uric Acid and Cardiovascular Risk in End-Stage Renal Disease (ESRD) Patients

Background: Chronic kidney disease (CKD) is a worldwide public health problem and an independent risk factor for cardiovascular disease (CVD). Objective: We assessed cardiovascular risk in end-stage renal disease (ESRD) patients and evaluated the relationship between serum uric acid (SUA) and lipoprotein subfractions. Methods: The study group consisted of 66 patients on dialysis and a control group of 25 healthy volunteers. Concentration of high-density lipoproteins (HDL) and low-density lipoproteins (LDL) subfractions were analysed using a Lipoprint™. Lipid profiles and SUA were measured. Results: Statistically significant differences between control and study group both with increased and normal SUA level were observed for HDL subfractions (1-5 [p = 0.0014 – 0.0001] and 7 – 10 [p=0.016], large and small HDL subfractions [p<0.0001]), LDL-2 subfraction [p = 0.016] and IDL-B [p = 0.015]. A significant decrease by 66% in CVD prevalence was found in dialysis patients with increased level of SUA (> 428 μmol/l) (p = 0.034). Association between SUA and CVD prevalence was independent of large, intermediate and small HDL subfractions as well as of very low-density lipoprotein (VLDL), intermediate- density lipoproteins-C, -B, -A (IDL-C, IDL-B and IDL-A). Conclusion: Our study demonstrated that higher SUA level might be associated with lower prevalence of CVD among haemodialysis patients. An elevated SUA concentration in haemodialysis population may be a marker of better nutritional status and also represent the antioxidant properties SUA.