High postprandial plasma remnant-like particles-cholesterol in patients with coronary artery diseases on chronic maintenance hemodialysis.

Abstract

The aim of this study was to determine the levels of postprandial plasma remnant-like particles-cholesterol (RLP-C) in patients with coronary artery disease (CAD) on chronic maintenance hemodialysis (HD). Forty-two patients on chronic maintenance HD with and without CAD were studied. The subjects took a meal within 1 hr before HD then underwent HD for 4 hr with heparin infusion. The plasma level of RLP-C was monitored before and during HD and its biochemical characteristics were analysed. In the CAD group, the RLP-C level was 5.9 +/- 3.5 mg/dl before HD and 6.9 +/- 4.6 mg/dl after HD. In patients without CAD, RLP-C levels before and after HD were 2.1 +/- 0.8 mg/ dl and 2.7 +/- 1.2 mg/dl respectively (within the normal range). The RLP-C levels between CAD and non-CAD were highly significant (p < 0.001). HPLC analysis of RLP revealed that VLDL remnants were reduced to smaller size, cholesterol rich particles within 1 hr of HD and a marked increase in chylomicron (CM) remnants was observed at the end of HD. These observations suggest that a latent metabolic disorder of chylomicrons and VLDL during HD after a meal can be detected by plasma RLP-C assay. The association between the frequency of latent metabolic lipoprotein disorders and CAD found in HD patients may require appropriate dietary intervention together with drugy therapy for the control of CAD.