Atherosclerosis risk factors related to hemodialysis duration and erythropoietin therapy

Patients undergoing hemodialysis are at risk for atherosclerosis and its complications. The aim of this study was to examine the effect of erythropoietin therapy and hemodialysis duration on some of the atherosclerotis risk factors. The patients were divided into four groups: I: patients undergoing hemodialysis for less than 10 years (n=22); II: patients undergoing hemodialysis for more than 10 years (n=17); III: patients on no erythropoietin (n=21); IV. patients on erythropoeitin therapy (n=18). A control group of 20 subjects was also examined. Triglycerides, total cholesterol, low-density lipoprotein and high-density lipoprotein, lipoprotein(a), apolipoprotein-A1, apolipoprotein-B and lipid peroxidation were examined. There was a significant increase in triglycericles, to 2.59 +/-1.2 mmol/l (p <0.001) and in lipid peroxidation in hemodialysis patients, to 5.02 +/-0.9 mu mol/l vs. controls (p <0.001). Significantly elevated triglycerides and lipid peroxidation levels were found in the patients with longer hemodialysis duration. Triglycerides were elevated in group II vs. group I, to 2.90 +/-1.0 mmol/l. (p <0.05). Lipid peroxidation in group II, 5.40 +/-1.0 mu mol/l, showed significant difference compared to group I (p <0.05). Erythropoietin treatment did not affect any of the examined parameters. These results indicate increased risk for atherosclerosis related to hemodialysis duration. Besides the renal disease itself, hemodialysis may also be one of the risk factors for atherosclerosis.