Kidney transplantation and statins effects on dyslipidemia in kidney transplant recipients

Dyslipidemia is very common after kidney transplantation (KTx), and it has been reported in up to 75% of KTx recipients (KTRs). Hence, statins are commonly used to control lipid levels post-KTx. Studies examining dyslipidemia and the effects of statins in KTRs receiving tacrolimus-based protocol remain limited particularly in the Middle East. This retrospective study examined the impact of KTx on lipids in Saudi KTRs.

Data from 287 KTRs from 2017 to 2020 were analyzed, comparing lipid profiles and HbA1c levels before and 12 months after KTx in those who received statins versus those who did not. The immunosuppression protocol consisted of tacrolimus, mycophenolate, and prednisolone.

195 (67.9%) of patients received statins during the first year post-KTx. In the present study, KTx alone led to an increase in total cholesterol (TC) by 0.31 mmol/L (P = 0.02) and low-density lipoproteins (LDLs) by 0.40 mmol/L (P < 0.01). However, despite weight gain and elevated HbA1c levels after KTx, KTx also resulted in an increase in high-density lipoproteins (HDLs) by 0.17 mmol/L (P < 0.01). Additionally, triglyceride (TG) levels decreased post-KTx. However, this change was not statistically significant. The use of statins alongside KTx improved HDL levels by 0.17 mmol/L (P < 0.01) and reduced TG by 0.34 mmol/L (P < 0.01). Statin users did not exhibit significant changes in TC or LDL levels. The mean changes in TC and LDL levels (from baseline to 12 months) were significantly different between statin users and non-users despite comparable weight gain and elevated HbA1c levels after KTx.

In conclusion, KTx was associated with improved HDL levels despite adverse effects on weight and HbA1c levels. The addition of statins to the treatment regimen not only maintained the positive effects of KTx on HDL and TG but also protected against increases in TC and LDL levels. These findings emphasize the potential benefits of KTx on HDL and TG levels in KTRs who received a tacrolimus-based immunosuppression protocol. Statin therapy modulates the LDL and TC increase seen post KTx.