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Published on: July 19, 2021
[Lipid spectrum and function of kidneys before and after liver transplantation]
1Kuban State Medical University; State Budgetary Healthcare Institution "Research Institute - Regional Clinical Hospital №1 n.a. professor S. V. Ochapovskiy" of Ministry of Health of Krasnodar Region.
Insights
Cardiovascular complications are a leading cause of death after liver transplantation. This study found that liver recipients often develop dyslipidemia and impaired renal function, which are closely linked and require timely medical attention.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Cardiovascular complications are the third leading cause of death in liver transplant recipients, following allograft failure and infections.
- Dyslipidemia and impaired renal function are key factors contributing to cardiovascular disease development in this patient population.
Purpose of the Study:
- To investigate lipid metabolism and renal function in liver transplant recipients in a real-world clinical setting.
- To assess the effectiveness of current clinical recommendations for managing dyslipidemia and chronic kidney disease (CKD) in these patients.
Main Methods:
- Retrospective analysis of lipid spectrum and renal function in liver transplant recipients.
- Measurement of creatinine and GFR (using CKD-EPI formula) and lipid profiles before and 36 months post-transplantation.
- Statistical analysis using Statistica 10.
Main Results:
- Liver recipients showed significantly increased total cholesterol (31.0%) and triglycerides before transplantation.
- Three years post-transplantation, cholesterol increased in 42.6% and triglycerides in 37.9% of patients.
- A 22.6% reduction in GFR was observed 3 years post-transplantation, with a significant inverse correlation between GFR and cholesterol/triglyceride levels.
Conclusions:
- Impaired lipid metabolism and decreased GFR are common in the long-term postoperative period after liver transplantation.
- Dyslipidemia is closely associated with the progression of renal dysfunction in liver transplant recipients.
- Increased physician attention is needed for timely correction of lipid disorders and early detection of renal dysfunction.
Background:
In patients after liver transplantation cardiovascular complications is the third main reason of death afer allograf failure and infections. The most important factors in the development of cardiovascular diseases are dyslipidemia and impaired renal function. The aim of the study was to investigate the lipid spectrum and renal function in liver recipients in real clinical practice and the correspondence of their correction to current clinical recommendations for the diagnosis and treatment of dyslipidemia and chronic kidney disease (CKD).
Methods:
A retrospective analysis of lipid spectrum and renal function in patients who underwent OLT in Research Institute - Regional Clinical Hospital №1, Krasnodar was performed. The level of creatinine, GFR and lipid spectrum was studied before and 36 months after liver transplantation. The GFR was calculated using the formula CKD‑EPI (Chronic Kidney Disease Epidemiology Collaboration). Statistical analysis of the study results was made using the program Statistica 10.
Results:
Liver recipients have a significantly higher total cholesterol by 31.0% (p<0.01) in comparison with the baseline before surgery. Total cholesterol was increased in 13.7% (p<0.01), triglycerides in 12.3% (p<0.01) before transplantation. Tree years after transplantation, the increasion in cholesterol was registered in 42.6% (p<0.01) and triglycerides in 37.9% (p <0.01), respectively. 3 years after transplantation reduction of GFR was observed in comparison with the baseline by 22.6% (p=0.00006). Verification of chronic kidney disease and statin administration in patients were carried out in some cases. The levels of total cholesterol and triglycerides had a reliable inverse correlation with GFR (r = ‑0.42; p<0.01 and r = ‑0.36; p<0.05).
Conclusions:
In the long‑term postoperative period there was an impaired lipid metabolism and decreased level of GFR. Dyslipidemia was closely related to the progression of renal dysfunction in liver recipients, an inverse correlation was established between the glomerular filtration rate and the increasion in cholesterol and triglyceride levels. It is necessary to increase the attention of physicians with regard to timely correction of lipid metabolism disorders and detection of initial manifestations of renal dysfunction.
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