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Scientific article
English

High prevalence of anti-apolipoprotein/A-1 autoantibodies in maintenance hemodialysis and association with dialysis vintage

Published inTherapeutic apheresis and dialysis, vol. 16, no. 6, p. 588-594
Publication date2012
Abstract

Autoantibodies to apolipoprotein/A-1 (anti-ApoA-1 IgG) have pro-atherogenic properties in patients at high cardiovascular risk, but its prevalence in patients with end-stage kidney disease is unknown. The aims of this single-center, cross-sectional study were to assess the prevalence of anti-ApoA-1 antibodies in patients on maintenance hemodialysis (MHD), and to examine its correlation with inflammatory biomarkers related to atherosclerotic plaque vulnerability and dialysis vintage. To this purpose, anti-ApoA-1 IgG levels and the concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), metalloproteinase-9 (MMP-9), tumor necrosis factor-α, and C-reactive protein (CRP) were assessed in the sera of 66 MHD patients (mean age: 68 ± 14 years, 36% women, 32% diabetics). Anti-ApoA-1 IgG positivity (defined as a blood value ≥ 97.5(th) percentile of the normal distribution as assessed in healthy blood donors) was 20%. Circulating levels of anti-ApoA-1 IgG correlated positively with dialysis vintage, but not with cardiovascular risk factors or previous cardiovascular events; no significant correlations were found between the anti-ApoA1 IgG levels and circulating levels of IL-6, IL-8, MCP-1, MMP-9, CRP, or low-density lipoprotein-cholesterol. In multivariable linear regression, adjusted for age and sex, only dialysis vintage remained positively and independently associated with anti-ApoA-1 titers (β = 0.05, 95% CI: 0.006; 0.28, P = 0.049). In conclusion, the prevalence of anti-ApoA-1 IgG is raised in the MHD-population, and positively associated with dialysis vintage, a major determinant of cardiovascular outcome. Whether antiApoA-1 antibodies play a role in the pathophysiology of accelerated atherosclerosis in the MHD-population merits further study.

Keywords
  • Aged
  • Aged, 80 and over
  • Apolipoprotein A-I/immunology
  • Atherosclerosis/immunology/physiopathology
  • Autoantibodies/immunology
  • Biological Markers/metabolism
  • Cross-Sectional Studies
  • Female
  • Humans
  • Immunoglobulin G/immunology
  • Inflammation/immunology
  • Kidney Failure, Chronic/therapy
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Plaque, Atherosclerotic/immunology
  • Prevalence
  • Renal Dialysis
  • Risk Factors
  • Time Factors
Citation (ISO format)
PRUIJM, Menno et al. High prevalence of anti-apolipoprotein/A-1 autoantibodies in maintenance hemodialysis and association with dialysis vintage. In: Therapeutic apheresis and dialysis, 2012, vol. 16, n° 6, p. 588–594. doi: 10.1111/j.1744-9987.2012.01102.x
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Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal1744-9979
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