Prevalence of apolipoprotein E genotypes in ischaemic cerebrovascular disease in end-stage renal disease patients

Background. Several studies have demonstrated that atherosclerotic complications are the major cause of morbidity and mortality in end-stage renal disease (ESRD) patients on dialysis. The allele ε4 of apolipoprotein E (ApoE) gene has been associated with an increased risk for ischaemic cerebrovascular disease (ICVD) in general populations in recent preliminary cross-sectional studies. Methods. The aim of our study was to prospectively investigate the risk of ischaemic cerebrovascular disease with respect to the presence of Apo ε4 allele in 157 Chinese uraemic patients. Results. During the 2 year follow-up, the incidence of stroke was 6.4% and the cumulative occurrence of ischaemic cerebrovascular disease was 9.6%. Further analysis showed that the cumulative occurrence of ischaemic cerebrovascular disease was 5.6% in subjects with no ApoE ε4 allele and 36.8% in those with one or two ApoE ε4 alleles. Univariate analysis showed that the prevalence of ischaemic cerebrovascular disease was significantly higher in the subjects with ApoE ε4 allele. The mean ApoA1 plasma concentrations was significantly lower in those with ApoE ε4 allele. A stepwise regression analysis showed that the presence of stroke was significantly related to the ApoE ε4 genotype (P < 0.001). Conclusions. The ApoE ε4 allele can be regarded as an important risk factor for ischaemic cerebrovascular disease in uraemic patients.