#1841 Lipoprotein(a) and chronic kidney disease: a descriptive study in a Spanish cohort

Abstract Background and Aims Chronic kidney disease (CKD) patients have an increased risk of cardiovascular disease (CVD). Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for CVD in general population. Studies suggest that the kidney has a role in Lp(a) catabolism, and Lp(a) levels are increased in kidney disease. This study aims to describe Lp(a) concentrations and to identify related clinical factors in non-dialysis CKD patients. Method Cross-sectional descriptive study. Inclusion criteria were adult patients (18 years or older) visited in the Nephrology Clinic between September 2024 and January 2025 that had a Lp(a) value. Clinical and laboratory data were collected from medical records. Statistical analysis was performed using SPSS version 15. Results Eighty-six adults were included, 32 (62.8%) males with a mean age of 69.2 ± 17.5 years. The prevalence of comorbidities included 74 patients (85.9%) with dyslipidemia, 63 (73.3%) with hypertension, 32 (37.2%) with diabetes and 9 (10.5%) with fatty liver disease. Twenty-eight patients (32.6%) had a history of cardiovascular events. The most frequent etiologies of CKD were vascular (21, 24.4%) and diabetic (19, 22.1%). Mean creatinine-based estimated GFR (eGFR) was 49.3 ± 22.8 mL/min, and mean cystatin C-based eGFR was 38.4 ± 22.9 mL/min. Most frequently prescribed antidiabetic drugs included SGLT2 inhibitors (48, 55.8%) and metformin (17, 19.8%), while 10 patients (11.8%) were also on insulin. Mean Lp(a) levels were 47.3 ± 60.5 mg/dL, with a median of 20.5 mg/dL (IQR 10–57.8). Mean values for the lipid panel were (in mg/dL): LDL-cholesterol, 84.7 ± 43.0; HDL-cholesterol, 53.4 ± 17.4; and triglycerides, 134.9 ± 72.9. Regarding lipid-lowering therapies, 66 patients (76.7%) were on statins, 31 (36.0%) on ezetimibe, 4 (4.7%) on bempedoic acid, 4 (4.7%) on fibrates and 2 (2.3%) on PCKS9 inhibitors. Bivariate analysis showed an association between Lp(a) levels and cystatin C based-estimated glomerular filtration rate (CysC-eGFR) (R2 0.221 P = 0.012). Patients with Lp(a) levels above the median had a higher urine albumin-to-creatinine ratio (22 mg/g, IQR 3–287.5 vs. 20 mg/g IQR 3–164.0, P = 0.041), and an increased prevalence of atrial fibrillation (23.8 vs. 14.7%, P = 0.011). Conclusion Lp(a) is an important predictor of cardiovascular events. Some studies have established a relationship between Lp(a) levels and chronic kidney disease. In our cohort, serum Lp(a) levels showed a correlation with a worse kidney function and higher albuminuria. Further implications of these associations need to be investigated in larger cohorts.