Hyperlipidemia is a common and important risk factor after
renal transplantation, but there is little long-term data on its incidence, pattern, and evolution in stable renal allograft recipients on low dose maintenance immunosuppression.
PATIENTS AND METHODS: A retrospective study was conducted on all patients who received kidney transplants from April 1, 1990 to March 31, 2000 at a single center, on their serial
lipid profile during the first 3 yr after
kidney transplantation.
RESULTS: A total of 221 (122 male, 99 female; mean age 37.8 +/- 10.0 yr at the time of
transplantation) Chinese adult renal allograft recipients were included. A 95.3% of patients were on
cyclosporine and
prednisolone based immunosuppression. Increases in total
cholesterol (TC),
low density lipoprotein (
LDL), and
high density lipoprotein (HDL) were noted, while the level of
triglyceride (TG) decreased after renal transplant. The incidence of
hypercholesterolemia (defined as TC >/= 6.3 mmol/L or
LDL >/= 4.2 mmol/L) within the first year was 28.2 and 20.3%, respectively. The incidence rate decreased significantly in the second (5.4%, p = 0.000 and 6.4%, p = 0.003) and third year (9.5%, p = 0.003 and 4.9%, p = 0.021), but the incidence of patients having a high risk-ratio (defined as TC/HDL >/= 5) remained unchanged (6.9, 4.9 and 10.3% within the first, second, and third year, respectively). Treatment with
statin was necessitated in 6.8, 13.6 and 21.7% of the patients at 1, 2, and 3 yr after
transplantation, respectively. The prevalence rates of elevated TC and
LDL were 18.3 and 18.9% at baseline, 40.6 and 33.3% after 1 yr, 32.8 and 27.3% after 2 yr, and 24.8 and 19.0% after 3 yr, despite treatment. The prevalence of patients with a high risk-ratio was 45.0% at baseline, 30.5% after 1 yr (p = 0.002), 22.6% after 2 yr (p = 0.000) and 21.8% after 3 yr (p = 0.000).
Hypercholesterolemia at the time of
transplantation was an independent predictor for post-transplant
hypercholesterolemia (odds ratio 3.76, 95% confidence interval 1.47-9.62, p = 0.006).
CONCLUSION: