In an open, prospective, multicenter study, stable renal graft recipients were converted to
tacrolimus because of
cyclosporine-related side effects. Seventy-five patients were switched primarily because of
hyperlipidemia. After the switch to
tacrolimus, mean total
cholesterol was reduced by 15% at month 6. One hundred seventy-seven additional patients were switched primarily for other indications:
hypertrichosis,
gingival hyperplasia, and arterial
hypertension, and these symptoms also improved after the switch. In this analysis, serum
lipid levels were categorized according to a modified standard classification of
lipid parameters for renal transplant patients (published by the NKF Work Group). The aim was to estimate the proportion of patients reaching normal
lipid levels after the conversion to
tacrolimus therapy. In patients with primary indication
hyperlipidemia, the proportion with normal
cholesterol levels increased significantly from 5.6% at baseline to 37.5% at month 6 (P < .05). For
LDL cholesterol, the increase was from 54.1% at baseline to 64.9% at month 6, and for
triglycerides the improvement was from 25.4% to 33.8%.
HDL cholesterol levels remained stable. Similar changes of
lipid parameters were also observed in the subgroups of patients converted to
tacrolimus primarily because of other indications. After conversion from
cyclosporine to
tacrolimus, a significantly higher proportion of stable renal graft recipients reached normal total
cholesterol levels. For
LDL cholesterol and
triglycerides, a trend for normalization was observed. Thus, the improvement of serum
lipid levels resulted for many patients in a change to a better level class and improved or normalized their cardiovascular risk parameters.