There is an increased risk of atherogenesis in adult patients with chronic renal failure (CRF). The aim of study was estimation of the risk of atherogenesis in children with advanced CRF and in children receiving renal replacement therapy. To evaluate the risk ApoA1 and ApoB concentrations were measured and ApoA1/ApoB index was calculated.
Results: Increased ApoA1 concentration was found in CADO group without any marked change in other groups. The relative capacity of protein part (ApoA1) of HDL seems to increase in both HD and CAPD children. But in case of ApoB (LDL) the same increase was observed only in HD children. The available data suggest that increased protein capacities of LDL and HDL are connected with lower diameter and modified properties (atherogenic potential) of those molecules. Normal ratio of ApoB/LDL in CAPD group is counterbalanced with increased serum concentration of LDL. A positive correlation between ApoA1/ApoB index value and total protein concentration that has been found in HD group suggests a role of several factors connected with dialysis regimen that affect nutrition status of HD patients. ApoA1/ApoB shows only medium level correlation with other classic indices based on total cholesterol, HDL and LDL concentrations.
Conclusion: The change of HDL and LDL concentration in children receiving renal replacement therapy failed to significantly affect ApoA1/ApoB index. This fact excluded the possibility to apply ApoA1/ApoB as a tool that could point out the better type of treatment. Taking together the available data describing the relation between protein capacity and size of lipoprotein molecules and our calculations, we suppose that CAPD is connected with slightly lower risk of atherogenesis than HD.