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Article: A long-term study on hyperlipidemia in stable renal transplant recipients

TitleA long-term study on hyperlipidemia in stable renal transplant recipients
Authors
KeywordsHypercholesterolemia
Hyperlipidemia
Incidence
Prevalence
Renal transplant
Issue Date2004
PublisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CTR
Citation
Clinical Transplantation, 2004, v. 18 n. 3, p. 274-280 How to Cite?
Abstract
Objectives: Hyperlipidemia is a common and important risk factor after renal transplantation, but there is little long-term data on its incidence, pattern, and evolution in stable renal allograft recipients on low dose maintenance immunosuppression. Patients and methods: A retrospective study was conducted on all patients who received kidney transplants from April 1, 1990 to March 31, 2000 at a single center, on their serial lipid profile during the first 3 yr after kidney transplantation. Results: A total of 221 (122 male, 99 female; mean age 37.8 ± 10.0 yr at the time of transplantation) Chinese adult renal allograft recipients were included. A 95.3% of patients were on cyclosporine and prednisolone based immunosuppression. Increases in total cholesterol (TC), low density lipoprotein (LDL), and high density lipoprotein (HDL) were noted, while the level of triglyceride (TG) decreased after renal transplant. The incidence of hypercholesterolemia (defined as TC ≥ 6.3 mmol/L or LDL ≥ 4.2 mmol/L) within the first year was 28.2 and 20.3%, respectively. The incidence rate decreased significantly in the second (5.4%, p = 0.000 and 6.4%, p = 0.003) and third year (9.5%, p = 0.003 and 4.9%, p = 0.021), but the incidence of patients having a high risk-ratio (defined as TC/HDL ≥ 5) remained unchanged (6.9, 4.9 and 10.3% within the first, second, and third year, respectively). Treatment with statin was necessitated in 6.8, 13.6 and 21.7% of the patients at 1, 2, and 3 yr after transplantation, respectively. The prevalence rates of elevated TC and LDL were 18.3 and 18.9% at baseline, 40.6 and 33.3% after 1 yr, 32.8 and 27.3% after 2 yr, and 24.8 and 19.0% after 3 yr, despite treatment. The prevalence of patients with a high risk-ratio was 45.0% at baseline, 30.5% after 1 yr (p = 0.002), 22.6% after 2 yr (p = 0.000) and 21.8% after 3 yr (p = 0.000). Hypercholesterolemia at the time of transplantation was an independent predictor for post-transplant hypercholesterolemia (odds ratio 3.76, 95% confidence interval 1.47-9.62, p = 0.006). Conclusion: Renal transplantation is associated with a characteristic pattern of dyslipidemia, with increased TC, LDL and HDL, and a decrease in TG. Patients with pre-existing hypercholesterolemia were at higher risk for post-transplant hypercholesterolemia. Although the incidence of hypercholesterolemia peaks within the first year after transplantation, this remains a long-term complication in a significant proportion of patients on low dose immunosuppressive medications. © Blackwell Munksgaard, 2004.
Persistent Identifierhttp://hdl.handle.net/10722/76269
ISSN
2013 Impact Factor: 1.486
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, KCen_HK
dc.contributor.authorLam, MFen_HK
dc.contributor.authorYip, PSen_HK
dc.contributor.authorLi, FKen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorChan, TMen_HK
dc.date.accessioned2010-09-06T07:19:26Z-
dc.date.available2010-09-06T07:19:26Z-
dc.date.issued2004en_HK
dc.identifier.citationClinical Transplantation, 2004, v. 18 n. 3, p. 274-280en_HK
dc.identifier.issn0902-0063en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76269-
dc.description.abstractObjectives: Hyperlipidemia is a common and important risk factor after renal transplantation, but there is little long-term data on its incidence, pattern, and evolution in stable renal allograft recipients on low dose maintenance immunosuppression. Patients and methods: A retrospective study was conducted on all patients who received kidney transplants from April 1, 1990 to March 31, 2000 at a single center, on their serial lipid profile during the first 3 yr after kidney transplantation. Results: A total of 221 (122 male, 99 female; mean age 37.8 ± 10.0 yr at the time of transplantation) Chinese adult renal allograft recipients were included. A 95.3% of patients were on cyclosporine and prednisolone based immunosuppression. Increases in total cholesterol (TC), low density lipoprotein (LDL), and high density lipoprotein (HDL) were noted, while the level of triglyceride (TG) decreased after renal transplant. The incidence of hypercholesterolemia (defined as TC ≥ 6.3 mmol/L or LDL ≥ 4.2 mmol/L) within the first year was 28.2 and 20.3%, respectively. The incidence rate decreased significantly in the second (5.4%, p = 0.000 and 6.4%, p = 0.003) and third year (9.5%, p = 0.003 and 4.9%, p = 0.021), but the incidence of patients having a high risk-ratio (defined as TC/HDL ≥ 5) remained unchanged (6.9, 4.9 and 10.3% within the first, second, and third year, respectively). Treatment with statin was necessitated in 6.8, 13.6 and 21.7% of the patients at 1, 2, and 3 yr after transplantation, respectively. The prevalence rates of elevated TC and LDL were 18.3 and 18.9% at baseline, 40.6 and 33.3% after 1 yr, 32.8 and 27.3% after 2 yr, and 24.8 and 19.0% after 3 yr, despite treatment. The prevalence of patients with a high risk-ratio was 45.0% at baseline, 30.5% after 1 yr (p = 0.002), 22.6% after 2 yr (p = 0.000) and 21.8% after 3 yr (p = 0.000). Hypercholesterolemia at the time of transplantation was an independent predictor for post-transplant hypercholesterolemia (odds ratio 3.76, 95% confidence interval 1.47-9.62, p = 0.006). Conclusion: Renal transplantation is associated with a characteristic pattern of dyslipidemia, with increased TC, LDL and HDL, and a decrease in TG. Patients with pre-existing hypercholesterolemia were at higher risk for post-transplant hypercholesterolemia. Although the incidence of hypercholesterolemia peaks within the first year after transplantation, this remains a long-term complication in a significant proportion of patients on low dose immunosuppressive medications. © Blackwell Munksgaard, 2004.en_HK
dc.languageengen_HK
dc.publisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CTRen_HK
dc.relation.ispartofClinical Transplantationen_HK
dc.subjectHypercholesterolemiaen_HK
dc.subjectHyperlipidemiaen_HK
dc.subjectIncidenceen_HK
dc.subjectPrevalenceen_HK
dc.subjectRenal transplanten_HK
dc.subject.meshAdrenal Cortex Hormones - adverse effectsen_HK
dc.subject.meshAdulten_HK
dc.subject.meshCyclosporine - adverse effectsen_HK
dc.subject.meshDieten_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHong Kongen_HK
dc.subject.meshHumansen_HK
dc.subject.meshHyperlipidemias - complications - epidemiologyen_HK
dc.subject.meshImmunosuppressive Agents - adverse effectsen_HK
dc.subject.meshIncidenceen_HK
dc.subject.meshKidney Transplantation - adverse effectsen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPrevalenceen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshRisk Factorsen_HK
dc.subject.meshTime Factorsen_HK
dc.titleA long-term study on hyperlipidemia in stable renal transplant recipientsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0902-0063&volume=18&issue=3&spage=274&epage=280&date=2004&atitle=A+long-term+study+on+hyperlipidemia+in+stable+renal+transplant+recipientsen_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.emailChan, TM: dtmchan@hku.hken_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1399-0012.2004.00160.xen_HK
dc.identifier.pmid15142048en_HK
dc.identifier.scopuseid_2-s2.0-2342667679en_HK
dc.identifier.hkuros86752en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-2342667679&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume18en_HK
dc.identifier.issue3en_HK
dc.identifier.spage274en_HK
dc.identifier.epage280en_HK
dc.identifier.isiWOS:000221354400008-
dc.publisher.placeDenmarken_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridLam, MF=35300050600en_HK
dc.identifier.scopusauthoridYip, PS=14219904600en_HK
dc.identifier.scopusauthoridLi, FK=8219093900en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK

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