Serum lipid pattern unifies following renal transplantation in children

Abstract

Hyperlipidemia is a common problem in solid organ transplant recipients. In this study we evaluated the role of pre-transplant renal replacement therapy on early and late changes of serum lipid levels in children following renal transplantation. In 46 children with chronic renal failure (median age 10.3 years) and 12 children with heart failure (median age 5.0 years), cholesterol and triglycerides were measured before and during follow-up after transplantation. Children with renal failure had significantly higher serum lipids than controls ( n=34, median age 9.2 years) and patients with heart failure. Pre transplantation, cholesterol and triglycerides were significantly lower in the hemodialysis than in the peritoneal dialysis population, whereas conservatively treated children had intermediate levels. After transplantation, serum cholesterol converged towards a mean level of 208 mg/dl and triglyceride levels converged towards a uniform level of 195 mg/dl at 9 months post transplant. The ratio of cholesterol/high-density lipoprotein significantly decreased from 4.7 to 3.8. The pattern of "post-transplant hyperlipidemia" was similar in both renal and cardiac allograft recipients. Hence, the early post-transplant changes of serum lipid pattern are markedly dependent on the mode of pre-transplant renal replacement therapy. Later, serum lipid levels were no longer influenced by prior renal replacement therapy and showed a new pattern of "post-transplant hyperlipidemia" in all children.

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

“…The mean TC and LDL values of our HD group were found to be normal. This is in agreement with the previously published data (37). Elevated TGs are commonly found in the chronic HD population.…”

Short‐ and long‐time effects of pediatric liver transplantation on serum cholesterol and triglyceride levels – The Vienna Cohort

“…In agreement, overall levels of immunosuppressive therapy clearly demonstrated a temporal association with the post-transplant course of hyperlipidemia. Our group has previously reported similar findings in renal transplant recipients in whom different patterns of pretransplant dyslipidemia observed in patients on hemodialysis vs. patients on peritoneal dialysis converged to a common post-transplant pattern of hyperlipidemia within the first year (16). In addition, we also found data suggestive for a role of liver allograft function for lipid metabolism, as decrease of cholesterol levels correlated with decrease of bilirubin levels.…”

Dyslipidemia among Sudanese Children Undergoing Maintenance Dialysis

“…Significantly elevated levels of serum TC were reported in two of these studies [10,18]. Likewise, high serum levels of TC and TGD have been reported in pediatric patients undergoing peritoneal dialysis in many previous studies [3,[20][21][22]. Alterations in lipid profiles were often found to be more pronounced in PD patients than HD patients [22][23][24][25].…”

“…Likewise, high serum levels of TC and TGD have been reported in pediatric patients undergoing peritoneal dialysis in many previous studies [3,[20][21][22]. Alterations in lipid profiles were often found to be more pronounced in PD patients than HD patients [22][23][24][25]. However, some studies observed no such difference in serum lipids on either type of dialysis treatments [20].…”