Lipoprotein(a) [1] (hypertriglyceridemia) Attman 30% (GFR 10) 62% [2] 25% apoproteins. (apos) (VLDL) (a) (lipoprotein(a)) [2] (IDL) (LDL) (HDL)

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1 apoprotein(a) [1] (hypertriglyceridemia) ttman (GFR) 15 30% (GFR 10) 62% [2] Lipoprotein(a) 25% apoprotein (chylomicron remnants) (apos) (IDL) (VLDL) (a) (lipoprotein(a)) [2] (LDL) (HDL) 2 apoproteins apoprotein(a) ap- poprotein oprotein C II apoprotein C III apoprotein Lipoprotein(a) (Lp(a)) I & apoprotein II apoprotein B ap- E (LDL) Lp(a) oprotein apoprotein(a) plasminogen Lp(a) (GFR) 60 ml/min poprotein(a) apo I/apo C III apo I/apo B ( HDL/LDL)

2 HDL 2 HDL 3 1) VLDL IDL (HDLtriglyceride) (dyslipoproteinemia) VLDL IDL (Hemodialysis) (CPD) LDL [3] CPD (Total cholesterol) CPD VLDL IDL (lipolytic VLDL IDL LDL enzymes) [8] Lipoprotein(a) (Lp (Lipoprotein lipase, LPL) (Hepatic triglyceride lipase, HTGL) LPL vram (1) (insulin resistance) (insulin deficiency) (2) CPD LPL apoprotein B apopro- (3) (enzyme cofactor) apo CII tein B CPD apo C III [4] apo I/apo B VLDL LPL [7] VLDL [5] CPD vram IDL VLDL (Lecithin: chlo- apoprotein B esterol acyl transferase, LCT) cofactor apo I II [6] LCT apoprotein B HDL LCT HDL ( CPD (LDL) (HDL) (a)) CPD

3 B LDL Cholesterol HTGL CE HDL 3 LCT HDL 2 C B B VLDL LPL IDL E E LPL-lipoprotein lipase, HTGL-hepatic trglyceride lipase. LCT-lecitin: cholesterol acyltransferase, CE-cholesterol esters. 1 CPD CPD ( 5 20 g/day) (nephrotic CPD syndrome) ( 1) [11] ( g/day) VLDL IDL VLDL [10] VLDL CPD LDL VLDL IDL CPD vram

4 CPD apoprotein B [15] CPD [7] poprotein IV apoprotein CPD HDL (ideal body weight) HDL 1/3 (erythropoietin) [9] apoproteins apo I apo B CPD HDL [16] HMG-Co (3-hydroxy-3- (LCT) poprotein IV methylglutaryl co-enzyme reductase apoproteins inhibitors) HMG-Co Lipoprotein(a) LDL LDL HDL CPD (fish oils) Lipoprotein(a) HMG-Co HDL Lipoprotein(a) ( CPK 500 IU/L ) CPD ( GOT GPT ) cholesterol-rich apo B containing lipoprotein [12] ttman fibrates apo I apo B (lipoprotein lipase) [13] CPD Lipoprotein(a) [14]

5 ω-3 (Omega-3 fatty acids) HDL LDL Probucol Nicotinic acid Resins (cholestyramine and colestipol) 1982; 17: (1) (Nutrineal) (2) (Extraneal: Icodextrin) Icodextrin 6% 10% [17] (CPD) 1. Scanu M, Fless GM: Lipoprotein (a). Heterogeneity and biological relevance. J Clin Invest 1990; 85: ttman PO, Samuelsson O, laupovic P: Lipoprotein metabolism and renal failure. m J Kidney Dis 1993; 21: Rajman I, Harper L, Kendall MJ, Wheeler DC: therogenic low-density lipoprotein subfraction profiles in dialysis patients. (abstract) J m Soc Nephrol 1995; 6: Chan MK, Persaud J, Varghese Z, Moorhead JF: Pathogenic roles of post-heparin lipases in lipid abnormalities in hemodialysis patients. Kidney Int 1984; 25: Chan MK, Varghese Z, Persaud JW, Baillod R, Moorhead JF: Hyperlipidemia in patients on maintenance hemo- and peritoneal dialysis: The relative pathogenetic roles of triglyceride production and triglyceride removal. Clin Nephrol 6. Guanieri GF, Morcchiello M, Campanacci L, et al: Lecithincholesterol acyltransferase (LCT) activity in chronic uremia. Kidney Int 1978; 13: S vram MM, Goldwasser P, Burrell DE, ntignani, Fein P, Mittman N: The uremic dyslipideinia: cross-sectional and longitudinal study. m J Kidney Dis 1992; 20: Llopart R, Donate T, Oliva J, et al: Triglyceride-rich lipoprotein abnormalities in CPD-treated patients. Nephrol Dial Transplant 1995; 10: Kagan, Bar-Khayim Y, Schafer Z, Fainaru M: Kinetics of peritoneal protein loss during CPD: II. Lipoprotein leakage and its impact on plasma lipid levels. Kidney Int 1990; 37: Lindholm B, Norbeck HE: Serum lipids and lipoproteins during continuous ambulatory peritoneal dialysis. cta Med Scand 1986; 220: Staprans I, Piel CF, Felts JM: nalysis of selected plasma constituents in continuous ambulatory peritoneal dialysis effluent. m J Kidney Dis 1986; 7: Wissler RW: Update on the pathogenesis of atherosolerosis. m J Med 1991; (Suppl 1B): 3S-9S. 13. ttman PO, laupovic P, Gustafson : Serum apolipoprotein profile of patients with chronic renal failure. Kidney Int 1987; 32: Cressman MD, Heyka RJ, Paganini EP, O'Neil J, Skibinski CI, Hoff HF: Lipoprotein (a) is an independent risk factor for cardiovascular disease in hemodialysis patients. Circulation 1992; 86: Lameireän, Bernaert P, Lambert MC, Vijt D: Cardiovascular risk factors and their management in patients on continuous ambulatory peritoneal dialysis. Kidney Int 1994; 46: S Jones RG, Dibble KB, Gibson J, et al: Effect of dietary fish oil on lipid abnormalites in patients on CPD. Perit Dial HMG-Co Int 1988; 8: Mistry CD, Gokal R, Peers E: The midas study group: randomized multicenter clinical trial comparing isosmolar Icodextrin with hyperosmolar glucose solutions in CPD. Kidney Int 1994; 46: