الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
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SUMMARY AND CONCLUSIONS
In the present study the changes in plasma
carnitine together with those of plasma lipids and
lipoproteins will follow in uremic patiens undergoing
chronic hemodialysis and peritoneal dialysis as well as
in patients with renal transplantation. since
apollpoprotelns are the most probable determinants of
the structural and function.1speclflclty of plasma
lipo~roteins (Attman et al., 1984). apolipoproteins A
h
andgwill be estimated in this study.
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The results were statistically analysed and the
following results were obtained
1 - Lipids and Lipoproteins
* Plasma triglyceride concentration was significantly
increased in uremic patients on conservative
treatment when compared with control group. After
dialysis, this increased plasma triglyceride
concentration was significantly decreased in
hemodialysis group but slightly decreased in
peritoneal dialyzed group.
* Significant hypertriglyceridemia was observed in
uremic patients on peritoneal dialysis in
comparison with hemodialyzed group.
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* Plasma total cholesterol was significantly
increased in uremic patients on conservative
treatment when compared with both control and
dialyzed groups. This increase was associated with
significantly increased LDL-cholesterol and
significantly decreased HDL-cholesterol.
* During dialysis procedure, LDL-cholesterol was
significantly decreased immediately after
dialysis, while HDL-cholesterol was slightly
increased in both dialyzed groups.
* After renal transplantation, significant
hypertriglyceridemia still existed., furthermore,
significant hypercholesterolemia was detected in
comparison with control group.
* Hypercholesterolemia in renal transplant subjects
was associated with significant decrease in HDLcholesterol
and non significant change in LDLcholesterol
in comparison with control group. But,
there were significant increases in HDLcholesterol
and LDL-cholesterol of renal
transplant subjects when compared with dialyzed
groups.
* Plasma total phospholipids were significantly
*
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increased in both undialyzed and renal transplant
groups in comparison with control group.
Significant decrease in HDL-phospholipids was
observed in all studied groups in comparison with
control group. Then it slightly and significantly
increased after initiation of dialysis and renal
transplantation respectively when compared with
undialyzed group.
* significant increase in LDL-phospholipids was
observed in undialyzed patients when compared with
control group, while, there was significant
decrease in renal transplant, hemodialyzed and
postperitoneal dialyzed groups.
2 - Apolipoproteins
There was significant decrease in apolipoprotein-A
in all studied groups when compared with controls.
*
* After initiation of dialysis and renal transplantation
there was significant increase in
apolipoprotein-A in both dialyzed and renal transplant
groups in comparison with undialyzed group,
but there was non significant change in
apolipoprotein-A concentration between renal
transplant and both dialyzed groups.
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* There was significant increase in apolipoprotein-B
in undialyzed group when compared with control
group. this increase was significantly decreased
after initiation of dialysis in both dialyzed
groups. Moreover, there was significant increase
in apolipoprotein-B in renal transplant group in
comparison with both dialyzed groups.
3 - Carnitine and Free Fatty Acids :
* There was significant increase in plasma carnitine
level in undialyzed group, when compared with
control group.
* In both pre-dialyzed groups and renal transplant
subjects there were non significant changes in
carnitine levels in comparison with controls.
* Immediately after dialysis, plasma carnitine was
significantly decreased when compared with predialyzed
level in both groups of dialysis.
* Free fatty acids were significantly increased in
undiayzed and both dialyzed groups, but slightly
increased in renal transplant group when compared
with control group.
* Immediately after dialysis, there was significant
increase in the levels of free fatty acids when
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compared with pre-dialyzed levels in both groups
of dialysis.
Finally, we could conclude that
* Hypertriglyceridemia of uremic patients and of
renal transplant subjects could result mainly from
decreased VLDL clearance by decreased lipoprotein
lipase and also, increased VLDL synthesis could
not be excluded.
* Dialysis procedure ameliorates partially the lipid
abnormalities in dialyzed patients but does not
reverse it completely. So, all uremic patients on
maintenance dialysis should perform kidney
transplantation.
* After kidney transplantation, lipid pattern abnormalities
still exists. So, lipid profile should be
done to detect any abnormality.
* Since cyclosporin A is used widely as immunosuppressive
agent after kidney transplantation.
effects of cyclosporin A on lipid metabolism
should be evaluated due to persistence of
hyperlipidemia in renal transplant subjects in our
study.
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* Estimation of apolipoprotein-A and apolipoprotein
B may detect lipid abnormalities in uremic
patients.
* In dialyzed patients, marked loss of carnitine
during dialysis may contribute in development of
hypertriglyceridemia in these patients, So,
carnitine must be estimated in uremic patients on
dialysis. Since carnitine has no any side effects
(as reported by Bizzi et al., 1979).
it can be added to dialysate in a concentration
corresponding to its plasma concentration to avoid
its excessive loss during dialysis.
* All methods used for estimation of carnitine were
depend on radioimmunoassay. In this study,
carnitine was estimated easily by colorimetric
method.