Badiou Stéphanie, Cristol Jean-Paul, Mourad Georges
Curr Diab Rep. 2009 Aug;9(4):305-11. doi: 10.1007/s11892-009-0047-0.
Lipid abnormalities are a common complication of kidney transplantation, occurring in up to 60% of patients. In fact, impairment of lipid metabolism is often present before renal transplantation due to the uremic state. After transplantation and recovery of renal function, lipid disturbances usually persist but show a different profile due to the various effects of immunosuppressive drugs on lipid metabolism. Actually, steroids, calcineurin inhibitors, and mammalian target of rapamycin inhibitors usually lead to quantitative and qualitative abnormalities of very low-density, low-density, and high-density lipoproteins. As cardiovascular diseases remain the leading cause of death in renal transplant recipients, management of dyslipidemia and other traditional risk factors, such as smoking, arterial hypertension, diabetes mellitus, and obesity, is of great importance to prevent cardiovascular complications and chronic allograft dysfunction. This review addresses the causes of dyslipidemia, the role of immunosuppressive drugs, and current recommendations to manage lipid disorders in renal transplant recipients.
脂质异常是肾移植常见的并发症，高达60%的患者会出现。事实上，由于尿毒症状态，脂质代谢受损往往在肾移植前就已存在。移植后肾功能恢复时，脂质紊乱通常会持续存在，但由于免疫抑制药物对脂质代谢的各种影响，其表现有所不同。实际上，类固醇、钙调神经磷酸酶抑制剂和雷帕霉素靶蛋白抑制剂通常会导致极低密度脂蛋白、低密度脂蛋白和高密度脂蛋白出现数量和质量上的异常。由于心血管疾病仍然是肾移植受者的主要死亡原因，因此管理血脂异常和其他传统风险因素，如吸烟、动脉高血压、糖尿病和肥胖，对于预防心血管并发症和慢性移植物功能障碍至关重要。本文综述了肾移植受者血脂异常的原因、免疫抑制药物的作用以及目前管理脂质紊乱的建议。
