Dyslipidemia After Kidney Transplantation and Correlation With Cyclosporine Level

Background: Dyslipidemia after kidney transplantation is a frequent finding and is multifactorial. Immunosuppressive agents such as cyclosporine (CsA) can cause hypercholesterolemia.

Objectives: As there were few reports with conflicting evidence on whether CsA related dyslipidemia is dose related and that CsA monitoring assays (trough level, C0, or two hour post dose level, C2) is a better predictor for dyslipidemia development; hence, the current study, in a large sample size, was designed to answer these questions.

3. Patients and Methods: In the current retrospective cross sectional study, 1391 kidney transplant recipients were enrolled. All patients received CsA plus mycophenolatemofetile or azathioprine and prednisolone. Serum creatinine, CsA blood levels and lipid profile were measured after 12-14 h fasting. Mann-Whitney and Kruskal-Wallis, Pearson`s test and logistic regression were used for data analyses.

Results: Mean age of 1391studied population was 38.7 15 years old. Hypercholesterolemia and hypertriglyceridemia were observed in 58.9% and 86.6%, respectively and they were more significantly detected in cadaveric kidney transplantation. Dyslipidemia had weak correlation with age of recipient, serum creatinine, C0 and C2 levels of CsA. At logistic regression, serum creatinine was the only risk factor for hypercholesterolemia development after kidney transplantation (OR = 1.6, CI 95%: 1.4 -1.8).

Conclusions: Dyslipidemia is a common finding after kidney transplantation and has no correlation with CsA level. According to conflicting data on the precise effect of different factors in inducing dyslipidemia, prospective large sample size studies should consider better control of dyslipidemia.