Comparison of Cardiac Risk Factors in Patients with Nephrotic Syndrome and Secondary Amyloidosis
Abstract
Proteinuria is an independent risk factor for cardiovascular diseases and for the increment of atherosclerotic mortality. Atherosclerotic risk factors are well known in the various types of nephrotic syndrome but there are only few studies comparing the same risk factors between the secondary amyloidosis and nephrotic syndrome patients those have exactly same 24- hour protein levels in the urine. According to theliterature, recent comparative studies have not shown the etiological differences of atherosclerotic risk factors in these two disease groups. The aim of this study was to investigate the risk factors caused byproteinuria on development of atherosclerosis and to determine the differences in these disease groups those were well- matched in age, gender, arterial blood pressure levels, glomerular filtration rate (GFR) and body mass index. These patients groups were chosen to have exactly the same 24- hour protein levels in urine. 29 patients with nephrotic syndrome, 30 patients with secondary amyloidosis and 30 people of control group were taken to the trial. C- reactive protein (CRP), fibrinogen, cholesterol, triglyceride, low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), lipoprotein -a [Lp(a)], apo- lipoprotein Al (apo Al), apolipoprotein B (apo B), apo- lipoprotein E (apo E), GFR and 24- hour protein in urine were compared between the patients and control groups.
In the patients groups; cholesterol, triglyceride, LDL-C, Lp(a), apo A, apo B, apo E and fibrinogen levels were
found much higher than the control group whereas HDL-C levels were lower (p<0.0l). When both disease groups are compared; total cholesterol, triglyceride, LDL-C, HDL-C, apo Al, apo B and apo E levels were higher in the nephrotic syndrome group compared to the secondary amyloidosis group (p<0,05), but in terms of CRP, fibrinogen, Lp
(a) levels. There was no difference between the patient groups .
As a result; Atherosclerotic risk factors are quite high in nephrotic syndrome and secondary amyloid patient groups with proteinuria, and patients with amyloidosis should be closely monitored for other atherosclerotic risk factors in addition to amyloid accumulating in the organs.
Keywords
Nephrotic Syndrome, Secondary Amyloidosis, Cardiovascular Risk factors
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