López V, Gutiérrez C, Gutiérrez E, Sola E, Cabello M, Burgos D, González Molina M
Nephrology Department, Hospital Universitario Carlos Haya, Malaga, Spain.
Transplant Proc. 2008 Nov;40(9):2925-6. doi: 10.1016/j.transproceed.2008.09.046.
Cardiovascular disease is the leading cause of death in kidney transplant recipients. Hyperlipidemia is a cardiovascular risk factor present in over 70% of recipients. Ezetimibe has proved effective for the treatment of dyslipidemia in these patients.
To evaluate the efficacy and safety of treatment with ezetimibe in kidney transplant recipients with uncontrolled hyperlipidemia.
We undertook a prospective study of 25 kidney transplant recipients with dyslipidemia who started treatment with 10 mg of ezetimibe. Statins were being taken by 96% of these patients. Monotherapy was used in one case. Measurements were made at baseline and after 3, 6, and 12 months of the lipid and hepatic profiles, CPK, lactose dehydrogenase, renal function and levels of immunosuppressive agents.
A significant reduction was noted in total cholesterol, low-density lipoprotein cholesterol, and triglycerides. No patient had changes in the hepatic profile, increased CPK and lactose dehydrogenase levels, or important adverse effects. Renal function remained stable, with no significant variations in plasma levels of the different immunosuppressive agents.
The use of ezetimibe associated with statins is an efficient and safe therapeutic alternative for the treatment of poorly controlled dyslipidemia in recipients of a kidney graft.
心血管疾病是肾移植受者的主要死因。高脂血症是超过70%的受者存在的心血管危险因素。依泽替米贝已被证明对治疗这些患者的血脂异常有效。
评估依泽替米贝治疗血脂控制不佳的肾移植受者的疗效和安全性。
我们对25例血脂异常的肾移植受者进行了一项前瞻性研究,这些患者开始服用10毫克依泽替米贝进行治疗。其中96%的患者正在服用他汀类药物。1例采用单药治疗。在基线以及治疗3、6和12个月后测量血脂和肝功能指标、肌酸磷酸激酶(CPK)、乳酸脱氢酶、肾功能以及免疫抑制剂水平。
总胆固醇、低密度脂蛋白胆固醇和甘油三酯显著降低。没有患者出现肝功能指标变化、CPK和乳酸脱氢酶水平升高或严重不良反应。肾功能保持稳定,不同免疫抑制剂的血浆水平无显著变化。
依泽替米贝与他汀类药物联合使用是治疗肾移植受者控制不佳的血脂异常的一种有效且安全的治疗选择。