Background: Patients with end-stage renal disease (ESRD) exhibit high morbidity as well as
mortality for atherosclerotic cardiovascular diseases (CVD). Therefore, we investigated differences in
individual lipoprotein classes and subclasses in ESRD patients under chronic high volume hemodiafiltration
(HV-HDF) in comparison with a control group. We also assessed the prognosis of these patients
and analyzed these parameters after 5 years follow-up.
Methods: 57 patients and 50 controls were enrolled. We analysed high density (HDL) and low density
(LDL) lipoprotein subfractions using the Quantimetrix Lipoprint(R) system. Subfractions were correlated
with selected clinical-biochemical parameters including risk factors for atherosclerotic CVD at the beginning
of and after 5 years follow-up.
Results: Fourteen patients survived the 5-year follow-up. Follow-up results revealed a shift toward
smaller HDL subfractions. In lipoproteins carrying apolipoprotein B, there was a shift of cholesterol
from very low density (VLDL) to intermediate density (IDL) lipoproteins and LDLs. Hypolipidaemic
therapy did not influence lipoprotein profiles in HV-HDF patients.
Conclusion: 1. HV-HDF patients exhibit specific lipid profiles with elevated triacylglycerol, low HDL
and LDL and higher content of cholesterol in remnant particles (VLDL and IDL) at the expense of large
LDL. HDL subfractions were linked to the number of risk factors for CVD in the control group only.
2. Baseline lipoprotein profiles did not differ between survivors and non-survivors. Non-survivors had
higher CRP and lower HDL-C. 3. During the 5 year follow-up period, cholesterol in HDL particles and
lipoproteins carrying apolipoprotein B redistributed in survivors towards smaller particles, thus resembling
the profile of control patients.