Dyslipidemia and its management after renal transplantation

Dyslipidemias are common after renal transplantation. Most common are elevations in total and low-density lipoprotein cholesterol. Causes of dyslipidemia are usually multiple, but include immunosuppression (especially prednisone, cyclosporine and sirolimus), graft dysfunction (reduced glomerular filtration rate and proteinuria), and genetic predisposition. There is a growing amount of evidence suggesting that dyslipidemias contribute to the very high incidence of cardiovascular disease after transplantation. Less well established is whether the associations between dyslipidemias and graft dysfunction are due to a causal role of lipid abnormalities on renal injury. In any case, hypercholesterolemia, and especially increases in low density lipoprotein cholesterol, should be treated using guidelines established for patients in the general population.