Lipid disturbances before and after renal transplant

Hyperlipidemia is a significant metabolic disorder that is commonly encountered in renal transplant recipients. This study was conducted to investigate lipid disturbances and define its pattern in kidney recipients.

The records of 103 patients who had undergone a renal transplant between the years of 2004 and 2005 were retrospectively investigated. The lipid profile of these patients including total cholesterol, low-density lipoproteins, high-density lipoproteins, and triglyceride levels before and within 2 years' follow-up after transplant was evaluated. The demographics of the patients, cause of the end-stage renal failure, along with their immunosuppressive regimens were also considered.

The study group included 43 women (41.8%) and 60 men (58.2%) (mean age, 39.25 ± 13.9 y). After transplant, laboratory analyses yielded significantly increased levels of total cholesterol, low-density lipoproteins, triglyceride levels, and high-density lipoproteins despite statin therapy, and the most important predictor for developing hypercholesterolemia and hypertriglyceridemia-pre-existing dyslipidemia. The effects of the various drugs on lipid metabolism were not different. These effects seen on the lipid profiles also were independent of the patients' age, sex, and cause of end-stage renal failure.

Despite statin treatment, renal transplants in our subjects were associated with a characteristic pattern of lipid disturbance with raised total cholesterol, low-density lipoproteins, high-density lipoproteins, and a concomitant increase in triglycerides. A more-aggressive approach to managing posttransplant hypercholesterolemia is warranted, especially in patients with pre-existing dyslipidemia.