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Journal of the Korean Society of Pediatric Nephrology 1997;1(2): 109-116.
투석 치료중인 만성 신부전 소아에서의 지질 및 지질단백 이상
김정수, 송정한, 박혜원, 정해일, 김진규, 최용, 고광욱
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 임상병리과학교실
3서울시립 보라매병원 소아과
4서울대학교 의과대학 소아과학교실
5서울대학교 의과대학 임상병리과학교실
6서울대학교 의과대학 소아과학교실
7서울대학교 의과대학 소아과학교실
Lipoprotein and Lipid Abnormalities in Uremic Children with Maintenance Dialysis
Jung-Sue Kim, Jung-Han Song, Hye-Won Park, Hae-Il Cheong, Jin-Q Kim, Yong Choi, Kwang-Wook Ko
1Department of Pediatrics, Seoul National University, College of Medicine
2Department of Clinical Pathology, Seoul National University, College of Medicine
3Department of Pediatrics, Seoul City Boramae Hospital
4Department of Pediatrics, Seoul National University, College of Medicine
5Department of Clinical Pathology, Seoul National University, College of Medicine
6Department of Pediatrics, Seoul National University, College of Medicine
7Department of Pediatrics, Seoul National University, College of Medicine
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ABSTRACT
Purpose : Chronic renal failure is often accompanied by severe dyslipidemia, a known risk factor for cardiovascular disease. Lipoprotein(a) [Lp(a)] has recently been characterized as a risk factor for atherosclerosis and thrombosis. Cardiovascular disease is the leading cause of death in adult patients on dialysis. However, there are only limited data available concerning risk factors for atherosclerosis in uremic children. We have measured serum levels of lipids, lipoproteins, apolipoproteins and Lp(a) in uremic children with maintenance dialysis.
Methods : Ten uremic children with hemodialysis (HD) and 14 with peritoneal dialysis (PD) in our dialysis unit were included in this study. The mean age of HD patients was $162{pm}59$ months and the male to female ratio was 7:3. The mean age and sex ratio of PD patients were $123{pm}63$ months and 6:8, respectively. The levels of cholesterol, triglyceride, lipoproteins, apolipoproteins and Lp(a) were measured from serum sampled after 14 hours of fasting. The normal control levels were cited from 2 articles presenting the normal blood lipid and lipoprotein levels of primary school and middle school children in Korea.
Results : There was no difference in age, sex ratio, body mass index and duration of dialysis between the HD and the PD group. The serum concentration of the cholesterol, triglyceride and apolipoprotein B were significantly elevated in dialysis patients compared with normal subjects. The serum level of Lp(a) was significantly elevated in only PD group. The serum Lp(a) level was below 30 mg/dl in 13 and above 30 mg/dl in 11 patients. The serum albumin level was significantly decreased in high Lp(a) group than in low Lp(a) group.
Conclusion : The uremic children receiving dialysis reveal abnormal serum lipid and lipoprotein profiles. These results suggest that they have a higher risk for coronary heart disease, although there has been no clinical evidence of coronary heart disease at present. A long-term follow-up study of these children to clarify the suggestion should be started now.
Key words: Uremia | Children | Dialysis | Lipid | Lipoprotein | Coronary hear disease
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