Hyperlipidemia in pediatric kidney transplant recipients treated with cyclosporine

Abstract

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.

Correlation between Cyclosporine Blood Levels and Area under Blood Concentration Time Curve in Iraqi Bone Marrow Transplant Patients Treated with Neoral® Oral Solution

“…The current investigation revealed that the common biochemical changes and adverse effects associated with cyclosporine therapy in Iraqi bone marrow transplant patients (Tables 5 and 6) were similar to that reported for Iraqi kidney transplant recipients [44,45]. Moreover, the primary biochemical changes and adverse effects of the drug reported in organ transplant patients of other nations were also identical to the present results such as electrolytes disturbances [46], hyperlipidemia [47], nephrotoxicity [48], cardiovascular risk [49], and elevation of blood pressure [50,51]. Unexpected biochemical changes and adverse effects of cyclosporine other than that found in literature and the current investigation were not registered.…”

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

“…found that 41% of 78 children treated with AZA, CSA, and high‐dose prednisone had elevated TC levels post‐TX (16). Mean CSA concentrations levels were significantly higher in recipients with elevated TC in this study (16). In another study of 30 transplanted children, hyperlipidemia was present in 66% (17).…”

“…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).…”

“…In addition to a reduced risk for the development of hyperlipidemia, tacrolimus has also been shown to significantly decrease the incidence of AR in comparison with CSA (29–31), thereby reducing the need for aggressive steroid therapy for the treatment of ARs. This is significant with regard to dyslipidemia because prednisone dosage has been correlated with increase in TC (14, 32) and TG levels (16, 22) in pediatric TX recipients.…”

Factors Affecting the Left Ventricular Mass Index in Children with Predialysis Chronic Renal Disease

“…Chavers ve ark. (29) 54 çocuk hastanın %54'ünde transplantasyon öncesi bakılan trigliserid düzeyini 200 mg/dl'den yüksek bulmuştur. Kronik böbrek yetmezlikli hastalarda hipertrigliserideminin yanı sıra artmış lipoprotein-A düzeyi koroner arter hastalığı için bağımsız bir risk faktörüdür (25) .…”