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 epsilon 4 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 epsilon 4 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 epsilon 4 allele and 36.8% in those with one or two ApoE epsilon 4 alleles. Univariate analysis showed that the prevalence of ischaemic cerebrovascular disease was significantly higher in the subjects with ApoE epsilon 4 allele. The mean ApoA1 plasma concentrations was significantly lower in those with ApoE epsilon 4 allele. A stepwise regression analysis showed that the presence of stroke was significantly related to the ApoE epsilon 4 genotype (P < 0.001).
Conclusions: The ApoE epsilon 4 allele can be regarded as an important risk factor for ischaemic cerebrovascular disease in uraemic patients.