Hypercholesterolemia which frequently follows
renal transplantation, places kidney graft recipients at an increased risk for
atherosclerosis and
cardiovascular diseases. We attempt in this study to determine the prevalence, and evaluate severity and treatment of
hypercholesterolemia in kidney transplant recipients. We studied 78 renal transplant patients with a mean age of 42.1 years and mean transplant duration of 6.2 years (range from six months to 8.5 years). They were on triple immunosuppressive therapy and had serum
creatinine level of less than 160micromol/L. Thirty-one patients (39.8%) were found to have blood
cholesterol levels > 6.4 mmol/L. Significant positive correlation was found between
hypercholesterolemia and
cyclosporine blood levels above 200 ng/ml (p< 0.0009). Furthermore,
proteinuria positively correlated with
hypercholesterolemia (p< 0.0006). There was no significant correlation between
cholesterol blood level and the patient age, sex, presence of diabetes,
prednisolone, dose, or treatment with C.-blockers and
diuretics.
Dietary modification was not effective in reducing the blood
cholesterol level in our patients, so we used
fluvastatin in a dose of 20 to 40 mg daily for a period of three months. This
drug was effective in lowering the mean
cholesterol blood levels from 7.1 to 5.2 mmol/L (p< 0.005). One out of 19-electromyogram studies showed abnormal pattern. We did not notice change in the levels of
creatinine phosphokinase, serum
creatinine or lover
enzymes. In conclusion, hyper-cholesterolemia is common in stable renal transplant patients. The presence of
proteinuria and the high level of blood
cyclosporine are significantly associated with
hypercholesterolemia. Low-dose
fluvastatin was well-tolerated and effective
cholesterol lowering treatment.