Plasma Lipids, Lipoproteins and Apolipoproteins AI, All, and B in Renal Transplanted Children: What Risk for Accelerated Atherosclerosis?

Goldstein, Sonia; Duhamel, G; Laudat, M H; Berthelier, M.; Hervy, C; Tête, Marie-Josèphe; Broyer, M.

doi:10.1159/000183287

Cited by 16 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hyperlipidemia, although present in our patient, is unlikely to have caused severe atherosclerosis. The risks for accelerated atherosclerosis due to hyperlipidemia are considered moderate in transplanted children and young adults [17]. Even patients with familial hyperlipidemia generally do not develop premature atherosclerosis that is as severe as in SIOD.…”

Section: Discussionmentioning

confidence: 99%

Generalized atherosclerosis sparing the transplanted kidney in Schimke disease

Lücke

Marwedel

Kanzelmeyer

et al. 2004

Pediatric Nephrology

View full text Add to dashboard Cite

Schimke-immuno-osseous dysplasia (SIOD) is a multisystem disorder caused by a mutation of the chromatin remodeling protein. The main clinical findings are spondyloepiphyseal dysplasia with disproportional growth deficiency, nephrotic syndrome with focal and segmental glomerulosclerosis, and defective cellular immunity. Transitory ischemic attacks due to vaso-occlusive processes are still an untreatable and life-limiting complication in patients with SIOD. The underlying pathophysiology of vaso-occlusive processes in SIOD is unclear. We report the clinical and pathological findings of the eldest published patient with the severe form of SIOD, who died at the age of 23 years due to pulmonary hypertension with subsequent right heart failure. The autopsy revealed a severe generalized atherosclerosis including the brain, heart, and pulmonary arteries. However, the kidney that was transplanted at the age of 5 years showed a good graft function without glomerular sclerosis and with only minimal nephrosclerosis on histology. Thus, the absence of severe vaso-occlusive processes in the transplanted organ and in the severely atherosclerotic host may indicate that the vaso-occlusive processes in SIOD are not caused by post-transplant cardiovascular morbidity such as arterial hypertension and hyperlipidemia. Instead, vascular factors of the host such as endothelial dysfunction may explain the pathophysiology of atherosclerosis in SIOD.

show abstract

Section: Discussionmentioning

confidence: 99%

Generalized atherosclerosis sparing the transplanted kidney in Schimke disease

Lücke

Marwedel

Kanzelmeyer

et al. 2004

Pediatric Nephrology

View full text Add to dashboard Cite

show abstract

“…Other investigators have found that prednisone dosage had no significant effect on TC or TG in pediatric recipients [7,18,19]. Milliner et al [7] reported that the prevalence of both hypercholesterolemia and hypertriglyceridemia decreased over time post Tx in pediatric recipients not on CsA; they found no change in TC or TG over time in 32 patients on CsA.…”

Section: Discussionmentioning

confidence: 99%

Hyperlipidemia in pediatric kidney transplant recipients treated with cyclosporine

2003

View full text Add to dashboard Cite

Hyperlipidemia is a risk factor for cardiovascular disease in adult kidney transplant (Tx) recipients. We sought to determine the prevalence of, and the risk factors associated with, hyperlipidemia in pediatric kidney Tx recipients on cyclosporine (CsA). We identified 59 patients (mean age 8.2±5.7 years) transplanted between 1 January 1991 and 31 December 1993. Pre Tx, 34% had elevated total cholesterol [TC >200 mg/dl (5.17 mmol/l)]; 54% had elevated triglycerides [TG >200 mg/dl (2.26 mmol/L)]. Mean TG was higher pre Tx in dialysis (versus nondialysis) patients: 306 mg/dl (3.46 mmol/l) versus 228 mg/dl (2.58 mmol/l) (P=0.04). Mean TC was higher in peritoneal dialysis than hemodialysis patients: 222 mg/dl (5.74 mmol/l) versus 169 mg/dl (4.37 mmol/l) (P=0.03). Pre Tx and 3-year values correlated (TC, r=0.49, P=0.0008; TG, r=0.41, P=0.001); 3-and 5-year TC values correlated (r=0.57, P=0.003). At 5 years post Tx, 41% of the recipients had elevated TC; 14% had elevated TG. Recipients with elevated TC had higher mean CsA concentrations at 1 year post Tx (P=0.03). Recipients with elevated TG tended to receive more prednisone (P=0.06). At 5 years post Tx, recipients had a high prevalence of hyperlipidemia. The identification and treatment of hyperlipidemia should be included in pediatric kidney Tx protocols.

show abstract

“…A few pediatric studies have investigated the role of CSA and prednisone in post‐TX hyperlipidemia. The prevalence of elevated TC reported in these studies ranged from 41% to 66%, and elevated LDL level was found in 72–84% of TX recipients (14–20). A major risk factor for the development of post‐renal TX dyslipidemia in both adults and children is the use of certain immunosuppressive (IS) medications (11, 21–25).…”

mentioning

confidence: 90%

Lipoprotein profile changes in children after renal transplantation in the modern immunosuppression era

Sgambat

He²,

McCarter³

et al. 2008

Pediatric Transplantation

View full text Add to dashboard Cite

There are little data on prevalence of dyslipidemia in pediatric kidney TX recipients in the modern IS era. LP profiles of 38 TX recipients receiving triple IS with MMF, prednisone, and tacrolimus were compared with those of 11 children on HD using mixed model multiple linear regression analysis of repeated measures after adjusting for age, sex, ethnicity, duration of ESRD, and BMI. TC and LDL levels were significantly higher in TX compared with HD, whereas there was no difference in the HDL, VLDL, and TG levels. TC and LDL in TX children had no association with age, sex, ethnicity, and duration of ESRD, stage of chronic kidney disease, DM, BMI percentile, and gain in percentage IBW. Five children treated with atrovastatin had a significant reduction in TC, LDL, VLDL, and TG at 3-6 months post-treatment compared with pretreatment levels, whereas there was no difference in HDL or tacrolimus levels after treatment. No side effects of therapy were observed. Although dyslipidemia remains a significant problem in pediatric renal TX recipients in the modern era, the prevalence may have decreased with use of newer IS drugs.

show abstract

Plasma Lipids, Lipoproteins and Apolipoproteins AI, All, and B in Renal Transplanted Children: What Risk for Accelerated Atherosclerosis?

Cited by 16 publications

References 21 publications

Generalized atherosclerosis sparing the transplanted kidney in Schimke disease

Generalized atherosclerosis sparing the transplanted kidney in Schimke disease

Hyperlipidemia in pediatric kidney transplant recipients treated with cyclosporine

Lipoprotein profile changes in children after renal transplantation in the modern immunosuppression era

Contact Info

Product

Resources

About