Hyperlipidaemia in renal transplant patients

Aakhus, Svend; Dahl, Ketil; Widerøe, Tor Erik

doi:10.1046/j.1365-2796.1996.474825000.x

Cited by 68 publications

(23 citation statements)

References 15 publications

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“…Notably, the HDL cholesterol levels of transplant recipients have been somewhat higher (approximately 55 mg/dL) than the population mean (3,5,26). This is a consequence of the use of corticosteroids, which increase HDL cholesterol levels (27,28).…”

Section: Discussionmentioning

confidence: 99%

“…Dimeny et al reported a mean serum cholesterol level of 262 mg/dL and an LDL cholesterol level of 175 mg/dL at 6 months after transplantation in 105 renal transplant recipients (29). Aakhus et al reported a mean total cholesterol level of 279 mg/dL in 403 transplant patients (26). Aker et al reported similar findings in 427 renal transplant recipients (3), with a mean cholesterol concentration of 273 mg/dL and a mean LDL cholesterol concentration of 189 mg/dL at 24 months after transplantation.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Sirolimus on Lipids in Renal Allograft Recipients: An Analysis Using the Framingham Risk Model

Blum

2002

American Journal of Transplantation

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This report describes the effects of sirolimus on plasma lipids, and uses the Framingham risk model to assess the clinical importance of these effects. Lipid data from two large controlled studies of 1295 renal transplant patients were analyzed retrospectively. Sirolimus 2 mg/day and 5 mg/day were compared with placebo or azathioprine, and administered concomitantly with steroids and cyclosporine over 12 months. Hypercholesterolemia and hypertriglyceridemia occurred in all treatment groups and were maximal at 2-3 months. The sirolimus groups evidenced higher lipid levels than the controls, but the elevations diminished over time. At 1 year, the patients given sirolimus 2 mg/ day had a mean cholesterol level 17 mg/dL greater and a mean triglyceride level 59 mg/dL greater than the controls. Among the patients given sirolimus 5 mg/day, mean cholesterol was 30 mg/dL greater and mean triglycerides were 103 mg/dL greater than the controls. Treatment with statins and fibrates was effective in reducing cholesterol and triglyceride levels, respectively, in the sirolimus-treated patients. The Framingham risk model predicted that the 17 mg/dL elevation in cholesterol would increase the incidence of coronary heart disease (CHD) by 1.5 new cases per 1000 persons per year and CHD death by 0.7 events per 1000 persons per year. Lipid elevations observed in the sirolimus-treated patients were manageable, improved over time, and responded to lipid-lowering therapy. Based on the Framingham risk model, the CHD risks associated with these cholesterol elevations are small compared with the baseline risks of the transplant population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of Sirolimus on Lipids in Renal Allograft Recipients: An Analysis Using the Framingham Risk Model

Blum

2002

American Journal of Transplantation

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“…They form the backbone of most immunosuppressive regimen, especially in renal transplant recipients. Cyclosporine can cause mild to moderate elevation in both total and LDL cholesterol and serum triglycerides [109][110][111]. Change in serum triglycerides and concomitant lowering of HDL cholesterol is less consistent than elevation in total and LDL cholesterol.…”

Section: Cyclosporinementioning

confidence: 99%

Drug-Induced Dyslipidemia

Simha

2015

Dyslipidemias

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“…Nevertheless, GCs have been shown to increase the energy intake in children with acute lymphoblastic leukemia (32). Obesity after TX has been considered a risk factor for dyslipidemia (33,34). In a previous study from our center, mild hyperlipidemia was a frequent finding in children under MP-AZA-CsA immunosuppression (47-56% after kidney TX), and the risk for dyslipidemia increased with an increasing age at TX (35).…”

Section: Methylprednisolone Exposurementioning

confidence: 99%

Methylprednisolone Exposure in Pediatric Renal Transplant Patients

Seikku

Raivio

Jänne

et al. 2006

American Journal of Transplantation

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Glucocorticoid (GC) dosing is commonly based on body mass or surface area in children, although the drug effects appear to correlate with steroid exposure, rather than dose. We compared the area under the serum concentration-time curve (AUC) of methylprednisolone (MP) with a recombinant cell bioassay measuring serum glucocorticoid bioactivity (GBA), in prediction of side effects in 16 pediatric patients (5.4-18.4 years of age) 2.0-14.9 years after renal transplantation (TX). They received 0.3 mg/kg of MP orally and timed blood samples were drawn up to 8 h postdose. Serum MP concentrations correlated moderately with GBA (r = 0.65, p < 0.0001) with best linear fit at 6 and 8 h (r = 0.72, 0.79, respectively, p < 0.001). MP-AUC t=0-8 and GBA t=6 were significantly greater in patients who gained excessive weight soon after TX. Change in growth after TX was inversely correlated with MP-AUC (r = 0.73, p < 0.05) and GBA t=6 (r = 0.62, p < 0.05). No correlation of MP-AUC or GBA was found with blood glucose or serum lipid concentrations, glomerular filtration rate, bone mineral density or graft histology. In conclusion, GC exposure varies individually and dosing should be adjusted accordingly to control the adverse effects. GBA might provide a complementary tool for monitoring GC exposure but further studies are needed.

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Hyperlipidaemia in renal transplant patients

Abstract: Hyperlipidaemia is prevalent after renal transplantation, and is associated with impaired graft function, hypertension, and with the use of beta blockers and diuretics, but not with the use of cyclosporine.

Cited by 68 publications

References 15 publications

Effects of Sirolimus on Lipids in Renal Allograft Recipients: An Analysis Using the Framingham Risk Model

Effects of Sirolimus on Lipids in Renal Allograft Recipients: An Analysis Using the Framingham Risk Model

Drug-Induced Dyslipidemia

Methylprednisolone Exposure in Pediatric Renal Transplant Patients

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