Background & Objectives: Lipoprotein [LP(a)] is formed by assembly of LDL particles and carbohydrate rich protein, apolipoprotein(a). LP(a) is elevated in patients with proteinuria or nephrotic syndrome, but it is still controversial whether this is due to hypoalbuminemia or proteinuria.

  Methods: We studied a group of 71 children suffering from nephrotic syndrome in the absence of renal failure. The levels of serum albumin, LP (a), triglyceride, total cholesterol, low density lipoprotein cholesterol (LDL-C) ,high density, lipoprotein- cholesterol (HDL- C), APOAI and APOB were measured by standard methods. The results were compared with those obtained from 75 age and sex matched normal children as control group. The concentrations of creatinin and protein in random urine samples obtained from children and the protein/creatinin ratio were calculated. The Relationship between measured parameters and/or serum albumin and proteinuria was evaluated.

  Results: Compared to the control group the serum levels of total cholesterol, triglycerides, LDL-C, LP (a), APOB and APOAI increated (p<0.05 in all cases), but no marked differences were observed in levels of HDL-C in case group. The levels of serum albumin in patient group were significantly lower than that of control (p<0.05). Serum levels of lipids and lipoproteins including APOAI and APOB were more correlated with plasma albumin level than with protein/creatinin ratio in the patient group.

  Conclusion: The results indicated that in children nephrotic syndrome with on renal failure, the increase of serum levels of LP (a) is mainly related to hypoalbuminemia that stimulates liver synthesis of APOB and is not related to the degree of proteinuria. It was concluded that determination of APOB is the best marker of hyperlipidemia in nephrotic syndrome and normal serum albumin levels seem to be a factor that may determine the of treatment efficacy of hyperlipidemia in nephrotic syndrome.