Factors influencing plasma lipid profiles including lipoprotein (a) concentrations in renal transplant recipients.
Fasting plasma cholesterol, triglycerides, high-density lipoprotein (HDL) and apoprotein (apo) B were elevated in 214 nondiabetic renal transplant recipients when compared to a reference group. Apo (a) was slightly but not significantly lower in transplant recipients (median 118 mg/dl, range 16-1680 vs 130 mg/dl, 10-1176) and this difference could be predicted from Lp (a) isoform analysis. Cholesterol, triglyceride, apo B and apo (a) concentrations correlated negatively with creatinine clearance but none of these parameters showed a significant association with proteinuria. Patients treated with steroids had higher plasma HDL concentrations than those receiving cyclosporin monotherapy (P < 0.01). The use of diuretics was associated with raised triglycerides (P < 0.001) and cholesterol (P < 0.01) and with reduced HDL (P < 0.01) whilst patients receiving beta-blockers had significantly higher triglycerides (P < 0.01) and lower HDL levels (P < 0.02). In multiple regression analysis, age (P < 0.01), creatinine clearance (P < 0.05) and diuretic therapy (P < 0.005) were independent risk factors for increased cholesterol whilst apo (a) levels correlated negatively with creatinine clearance (P < 0.005). These results suggest that impaired renal function, steroids and non-immunosuppressive drugs contribute to lipid abnormalites in renal transplant recipients.
Wheeler
D C
DC
Renal Transplant Unit, Cardiff Royal Infirmary, Wales, UK.
Morgan
R
R
Thomas
D M
DM
Seed
M
M
Rees
A
A
Moore
R H
RH
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D016632:Apolipoprotein A-I / Q000097:blood; D001053:Apolipoproteins / Q000097:blood* / Q000235:genetics; D001055:Apolipoproteins B / Q000097:blood; D053241:Apoprotein(a); D002784:Cholesterol / Q000097:blood*; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000502:physiology*; D017270:Lipoprotein(a); D008074:Lipoproteins / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D010641:Phenotype; D011239:Prednisolone / Q000627:therapeutic use; D012044:Regression Analysis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
D000319:Adrenergic beta-Antagonists; D016632:Apolipoprotein A-I; D001053:Apolipoproteins; D001055:Apolipoproteins B; D004232:Diuretics; D007166:Immunosuppressive Agents; D017270:Lipoprotein(a); D008074:Lipoproteins; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; D016572:Cyclosporine; D002784:Cholesterol; D011239:Prednisolone; D003404:Creatinine; D053241:Apoprotein(a)