Hyperlipidemia and transplantation: etiologic factors and therapy

J D Pirsch; A M D'Alessandro; H W Sollinger; S J Knechtle; A Reed; M Kalayoglu; F O Belzer

doi:10.1681/ASN.V212s238

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Hyperlipidemia and transplantation: etiologic factors and therapy

Journal article

Open access

Peer reviewed

Hyperlipidemia and transplantation: etiologic factors and therapy

J D Pirsch, A M D'Alessandro, H W Sollinger, S J Knechtle, A Reed, M Kalayoglu and F O Belzer

Journal of the American Society of Nephrology, Vol.2(12 Suppl), pp.S238-S242

06/1992

DOI: 10.1681/ASN.V212s238

PMID: 1498281

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Abstract

Hyperlipidemia is a well-recognized complication of renal transplantation. In long-term survivors of renal transplantation, cardiovascular disease accounts for the majority of patient deaths. In the cyclosporine era, cardiovascular disease has surpassed infection as the number one cause of death. Risk factors in the transplant population for hyperlipidemia include age, male sex, diabetes, prednisone dose, graft impairment, obesity, and antihypertensive therapy. Recently, cyclosporine has been implicated as an aggravating factor in the development of hyperlipidemia after transplantation, although its role has been controversial. Because renal transplant recipients have other significant risk factors for the development of coronary artery disease, the amelioration of hyperlipidemia may improve long-term patient survival. Because most late deaths occur in patients with a functioning graft, long-term graft survival could also be improved. The role of corticosteroids in the development of hyperlipidemia is well established. Recent studies employing corticosteroid withdrawal after transplantation have shown a marked reduction in cholesterol despite the use of cyclosporine. Data on corticosteroid withdrawal in living related transplants at our center show a significant reduction in total cholesterol after steroid withdrawal. Data from heart transplant recipients under corticosteroid-free protocols show a similar reduction in total cholesterol. Other treatments for hyperlipidemia include diet and cholesterol-lowering agents, such as Mevacor (lovastatin; Merck Sharp & Dohme, West Point, PA). The efficacy of lowering cholesterol in this high-risk population is unknown.

Adrenal Cortex Hormones - adverse effects

Antihypertensive Agents - adverse effects

Coronary Disease - etiology

Coronary Disease - prevention & control

Diuretics - adverse effects

Gemfibrozil - therapeutic use

Humans

Hyperlipidemias - diet therapy

Hyperlipidemias - drug therapy

Hyperlipidemias - etiology

Immunosuppressive Agents - adverse effects

Kidney Failure, Chronic - blood

Kidney Failure, Chronic - surgery

Kidney Transplantation

Lipid Metabolism

Lipoprotein Lipase - deficiency

Lovastatin - therapeutic use

Postoperative Complications - etiology

Risk Factors

Details

Title: Subtitle: Hyperlipidemia and transplantation: etiologic factors and therapy
Creators: J D Pirsch - University of Wisconsin–Madison
A M D'Alessandro
H W Sollinger
S J Knechtle
A Reed
M Kalayoglu
F O Belzer
Resource Type: Journal article
Publication Details: Journal of the American Society of Nephrology, Vol.2(12 Suppl), pp.S238-S242
DOI: 10.1681/ASN.V212s238
PMID: 1498281
NLM abbreviation: J Am Soc Nephrol
ISSN: 1046-6673
eISSN: 1533-3450
Language: English
Date published: 06/1992
Academic Unit: Accounting; Surgery
Record Identifier: 9984322936402771

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