Andany M A, Kasiske B L
Department of Medicine Hennepin County Medical Center, Minneapolis, MN 55415, USA.
J Nephrol. 2001 Nov-Dec;14 Suppl 4:S81-8.
Dyslipidemias are common after renal transplantation. Most common are elevations in total and low-density lipoprotein cholesterol. Causes of dyslipidemia are usually multiple, but include immunosuppression (especially prednisone, cyclosporine and sirolimus), graft dysfunction (reduced glomerular filtration rate and proteinuria), and genetic predisposition. There is a growing amount of evidence suggesting that dyslipidemias contribute to the very high incidence of cardiovascular disease after transplantation. Less well established is whether the associations between dyslipidemias and graft dysfunction are due to a causal role of lipid abnormalities on renal injury. In any case, hypercholesterolemia, and especially increases in low density lipoprotein cholesterol, should be treated using guidelines established for patients in the general population.
肾移植后血脂异常很常见。最常见的是总胆固醇和低密度脂蛋白胆固醇升高。血脂异常的原因通常是多方面的，但包括免疫抑制（尤其是泼尼松、环孢素和西罗莫司）、移植肾功能不全（肾小球滤过率降低和蛋白尿）以及遗传易感性。越来越多的证据表明，血脂异常导致移植后心血管疾病的高发病率。血脂异常与移植肾功能不全之间的关联是否归因于脂质异常对肾损伤的因果作用，这一点尚不明确。无论如何，高胆固醇血症，尤其是低密度脂蛋白胆固醇升高，应按照针对普通人群患者制定的指南进行治疗。
