STUDY OF DYSLIPIDEMIA IN KIDNEY TRANSPLANT RECIPIENTS

Introduction:

Dyslipidemia is common among transplanted patients, and it plays a role in the inferior survival of the graft as well as the patient. Despite significant improvement in graft survival in the recent past, recipient survival is low compared to the normal population with most mortality being related to macrovascular disease in kidney transplant recipients. We studied the prevalence and risk factors for lipid abnormalities in kidney transplant recipients in the first 3 months after transplantation.

Methods:

This was a single centre prospective observational study which was carried out in patients undergoing kidney transplant at Jaslok Hospital and Research Centre, Mumbai. Seventy patients undergoing kidney transplant irrespective of Age, Sex, Donor status (live versus deceased donor), Renal replacement therapy (RRT) modality (Hemodialysis versus Peritoneal dialysis), ABO compatibility were included. Patients already on lipid lowering drugs, patients having intercurrent infection, patients having hypothyroidism or liver disease were excluded. Follow-up period was 3 months post-transplant.

Prevalence and pattern of dyslipidemia was studied and its association with traditional risk factors, immunosuppressant use, renal function, episodes of rejection and pretransplant dyslipidemia was studied.

Results:

Out of 70 patients, 49 (70%) were male and 21(30%) were females. Overall mean ± SD age was 39.3±13.02 years and mean BMI was 22.3±4.26 kg/m2.

Majority of the patients were maintained on Tacrolimus + Mycophenolate (98.6%) while only 1 patient was on Cyclosporine + Mycophenolate. All patients received tapering doses of prednisolone.

Acute cellular rejection was seen in 6 (8.57%) patients, acute tubular injury in 5 (7.14 %) while antibody mediated rejection was seen in 2 (2.85 %) patients. Cardiovascular event in the form of myocardial infarction was seen in one patient.

1.Pattern of dyslipidemia

At 3 months post-transplant period, hypercholesterolemia and hypertriglyceridemia was observed in 8.6% and 30% patients respectively and prevalence of High LDL and Low HDL was 32.9% and 51.4% respectively.

2. Risk factors association with dyslipidemia

Significant association was not observed between dyslipidemia and sex, comorbidities, BMI, duration of dialysis, donor distribution (live vs deceased), induction agent used, dose of maintenance immunosuppression (tacrolimus <4mg vs >4mg, MMF<1gm vs >1 gm, prednisolone <5mg vs >5mg after 3 month of renal transplant.

No association was observed between dyslipidemia and adverse events like rejection, or acute tubular necrosis.

Age and serum creatinine were significant risk factors for Dyslipidemia.

Conclusions:

The lipid abnormalities seen after renal transplant is a complex mixture, attributable partly to the traditional risk factors and partly to the immunosuppressant medications and impaired renal function. Only one patient in the study had cardiovascular event (Myocardial infarction), probably a longer study duration will give a better insight into the association with dyslipidemia.

Assessment of lipid profile should be initiated soon after renal transplantation, as dyslipidemia is more prevalent in early post-transplant period, and should be followed up for prevention of risk of coronary artery disease and other macrovascular disease.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.