Lipoprotein‐associated phospholipase A2 predicts lower limb ischemia in hemodialysis subjects

• Published in: Therapeutic apheresis and dialysis Vol. 24; no. 5; pp. 548 - 553
• Main Authors: De Mauri, Andreana, Vidali, Matteo, Chiarinotti, Doriana, Dianzani, Umberto, Rolla, Roberta
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.10.2020
• Subjects: foot ulcers; hemodialysis; lipoprotein‐associated phospholipase A2; lower limb ischemia; peripheral arterial disease; hemodialysis; peripheral arterial disease; lipoprotein-associated phospholipase A2; lower limb ischemia; foot ulcers
• ISSN: 1744-9979; 1744-9987; 1744-9987
• DOI: 10.1111/1744-9987.13465

Hemodialyzed patients (HD) have high prevalence of peripheral arterial disease. In the general population, lipoprotein‐associated phospholipase A2 (Lp‐PLA2) is associated with peripheral arterial disease but no data are available for renal subjects. The aim of this study was to evaluate the relationship between Lp‐PLA2 and lower limb ischemia among dialyzed patients. One hundred and two dialyzed subjects, with median (IQR) age of 71 (59‐78) years, enrolled in June 2013 and followed until June 2018, were investigated for Lp‐PLA2 activity and the occurrence of peripheral arterial disease and lower limb ischemia. The median (IQR) levels of Lp‐PLA2 were 184 nmol/min/mL (156.5‐214.5). The 43 HD patients with abnormal Lp‐PLA2 activity (>194 nmol/min/mL) had higher levels of total and LDL‐cholesterol, ApoB/A1 ratio, and higher occurrence of lower limb ischemia during the follow up (44% vs 17%, P = .003). In multivariate analysis, Lp‐PLA2 activity (P = .018) and diabetes (P < .001) were independently associated with time to lower limb ischemia, and when the presence of previous PAD was added to the multivariate model, only presence of previous PAD (P < .001) and Lp‐PLA2 (P = .003) remained associated. Lp‐PLA2 is an independent predictor of lower limb ischemia in dialyzed patients.