Relationship between lipoprotein(a) and renal function: evidence from a cross-sectional analysis
S Azevedo, D Silva Correia, R Barbosa Sousa, A Silva, A Jorge Garcia, R Gomes, A Rita Bello, A Catarina Ribeiro, G Cunha, M Trabulo, J Figueira, J FerreiraAbstract
Introduction
Lipoprotein(a) [Lp(a)] is a genetically regulated risk marker of atherosclerotic cardiovascular disease (ASCVD). Elevated Lp(a) levels have been linked to chronic kidney disease (CKD), potentially indicating impaired renal clearance and associated metabolic imbalances. This study aims to explore the relationship between Lp(a) levels and estimated glomerular filtration rate (eGFR), shedding light on its clinical relevance in renal function assessment.
Methods
This cross-sectional study included 301 patients recruited between May 2023 and October 2024. Plasma Lp(a) levels were categorized based on European Atherosclerosis Society thresholds: Lp(a)<75 nmol/L and Lp(a)>100 nmol/L. eGFR was calculated using the Cockcroft-Gault equation. Correlations between Lp(a) and eGFR were assessed using Spearman’s rank coefficient, with p<0.05 considered statistically significant.
Results
The mean age of the cohort was 63±1 years, with 79.1% male. Comorbidities included hypertension (65.1%), dyslipidemia (64.8%), and diabetes (24.6%). Median Lp(a) levels were 65 nmol/L (IQR: 22–180 nmol/L), and mean eGFR was 83±2 mL/min/1.73m². A significant inverse correlation was observed between Lp(a) and eGFR (r=-0.112, p=0.027). Patients with Lp(a)>100 nmol/L had lower mean eGFR (77±3 mL/min/1.73m²) compared to those with Lp(a)<75 nmol/L (85±3 mL/min/1.73m²; p=0.033). An incremental rise in Lp(a) levels with declining eGFR was noted across CKD stages, although significance in advanced stages was limited by small sample sizes.
Conclusion
Elevated Lp(a) levels were associated with reduced eGFR. While cross-sectional data limit causal inference, Lp(a) may contribute for the increased risk of ASCVD in patients with renal impairment. Future longitudinal studies are warranted to confirm these findings and explore therapeutic strategies targeting Lp(a).For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.