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Effect of atorvastatin therapy and conversion to tacrolimus on hypercholesterolemia and endothelial dysfunction after

Karl Martin Wissing1, Philippe Unger, Lydia Ghisdal

  • 1Department of Nephrology, CUB-Hopital Erasme, Brussels, Belgium. wissing@ulb.ac.be

Transplantation
|September 29, 2006
PubMed

Insights

Atorvastatin is more effective than switching from cyclosporine A to tacrolimus for managing hypercholesterolemia in kidney transplant patients, significantly improving endothelial function.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Hypercholesterolemia is a common issue in kidney transplant recipients on cyclosporine A (CsA).
  • The optimal management strategy, statins versus switching to tacrolimus (TRL), remains uninvestigated.

Purpose of the Study:

  • To compare the efficacy of atorvastatin therapy versus switching from CsA to TRL in managing hypercholesterolemia.
  • To assess the impact of these interventions on endothelial function in renal transplant patients.

Main Methods:

  • A crossover study involving 12 CsA-treated kidney transplant recipients with hypercholesterolemia.
  • Patients were treated with CsA alone, CsA plus atorvastatin, TRL alone, and TRL plus atorvastatin.
  • Lipid profiles, LDL oxidation markers, and flow-mediated brachial artery vasodilatation (FMD) were measured.

Main Results:

  • Atorvastatin significantly reduced total cholesterol and LDL-C more effectively than switching to TRL.
  • Combination therapy with TRL and atorvastatin showed no additional benefit over CsA with atorvastatin.
  • Atorvastatin improved FMD, indicating enhanced endothelial function, while TRL showed a minor improvement.

Conclusions:

  • Atorvastatin is a superior treatment for hypercholesterolemia in CsA-treated renal transplant patients compared to switching to TRL.
  • Atorvastatin therapy significantly improves endothelial dysfunction in this patient population.
Abstract

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