Abnormal lipid metabolism after renal transplantation

The evidence that lipid disorders in patients following renal transplantation play a major role in the pathogenesis of atherosclerosis and chronic renal allograft rejection is circumstantial. The high rate of clinical vascular disease and cardiovascular complications in renal transplant recipients, the high prevalence of an atherogenic dyslipidemia and the evidence from the statin regression trials in the general population suggest that lipid lowering treatment is beneficial in patients after renal transplantation. In addition, animal models and observational studies in patients have demonstrated correlations between plasma lipid levels and both acute and chronic rejection. Animal transplant models and clinical trials in heart transplant patients also suggest that statin treatment decreases the incidence of chronic rejection. However, the mechanisms behind this protective effect remain unsolved and no conclusive data exist proving that statins directly inhibit the development of chronic rejection. However, sufficient evidence exists to consider the use of these agents in the posttransplant setting for their possible effects on cardiovascular complications.