Razeghi Effat, Shafipour Mohammadreza, Ashraf Haleh, Pourmand Gholamreza
Urology Research Center, Sina Hospital, Medical Sciences/University of Tehran, Hassan-Abad Sq., Tehran, Iran.
Exp Clin Transplant. 2011 Aug;9(4):230-5.
Hyperlipidemia is a significant metabolic disorder that is commonly encountered in renal transplant recipients. This study was conducted to investigate lipid disturbances and define its pattern in kidney recipients.
The records of 103 patients who had undergone a renal transplant between the years of 2004 and 2005 were retrospectively investigated. The lipid profile of these patients including total cholesterol, low-density lipoproteins, high-density lipoproteins, and triglyceride levels before and within 2 years' follow-up after transplant was evaluated. The demographics of the patients, cause of the end-stage renal failure, along with their immunosuppressive regimens were also considered.
The study group included 43 women (41.8%) and 60 men (58.2%) (mean age, 39.25 ± 13.9 y). After transplant, laboratory analyses yielded significantly increased levels of total cholesterol, low-density lipoproteins, triglyceride levels, and high-density lipoproteins despite statin therapy, and the most important predictor for developing hypercholesterolemia and hypertriglyceridemia-pre-existing dyslipidemia. The effects of the various drugs on lipid metabolism were not different. These effects seen on the lipid profiles also were independent of the patients' age, sex, and cause of end-stage renal failure.
Despite statin treatment, renal transplants in our subjects were associated with a characteristic pattern of lipid disturbance with raised total cholesterol, low-density lipoproteins, high-density lipoproteins, and a concomitant increase in triglycerides. A more-aggressive approach to managing posttransplant hypercholesterolemia is warranted, especially in patients with pre-existing dyslipidemia.
高脂血症是肾移植受者中常见的一种重要代谢紊乱疾病。本研究旨在调查肾移植受者的脂质紊乱情况并确定其模式。
回顾性调查了2004年至2005年间接受肾移植的103例患者的记录。评估了这些患者在移植前及移植后2年随访期间的血脂谱,包括总胆固醇、低密度脂蛋白、高密度脂蛋白和甘油三酯水平。还考虑了患者的人口统计学特征、终末期肾衰竭的病因及其免疫抑制方案。
研究组包括43名女性(41.8%)和60名男性(58.2%)(平均年龄39.25±13.9岁)。移植后,尽管使用了他汀类药物治疗,但实验室分析显示总胆固醇、低密度脂蛋白、甘油三酯水平和高密度脂蛋白水平均显著升高,而发生高胆固醇血症和高甘油三酯血症的最重要预测因素是移植前已存在的血脂异常。各种药物对脂质代谢的影响并无差异。这些血脂谱变化也与患者的年龄、性别和终末期肾衰竭的病因无关。
尽管使用了他汀类药物治疗,但我们研究对象的肾移植仍伴有特征性的脂质紊乱模式,即总胆固醇、低密度脂蛋白、高密度脂蛋白升高,同时甘油三酯也随之升高。对于移植后高胆固醇血症的管理,尤其是对于移植前已存在血脂异常的患者,有必要采取更积极的治疗方法。