Long term efficacy of simvastatin in renal transplant recipients treated with cyclosporine or tacrolimus.
BACKGROUND
Hyperlipidemia is frequently developed following renal transplantation and results in worsening of the patient's prognosis.


METHODS
In this study, 14 patients who had hypercholesterolemia [total cholesterol (TC) >200 mg/dL] and hypertriglyceridemia [triglyceride (TG) >150 mg/dL] 1 month after renal transplantation (post-transplantation), seven patients each under the treatment with immunosuppressant, either cyclosporine or tacrolimus started simvastatin treatment of 5-10 mg/d and continued the treatment for 4 yr. The effect of simvastatin treatment was assessed by comparison in serum lipid levels (TC, TG, cholesterol in lipoprotein fractions, and apolipoproteins) and the lipid metabolism related enzyme activities for post-transplantation, after 6-month and 4-yr simvastatin treatment.


RESULTS
Simvastatin treatment of 4 yr significantly decreased the elevated levels of serum TC from 234.5 +/- 30.8 to 186.3 +/- 20.5 mg/dL (p < 0.001), low density lipoprotein cholesterol (LDL-C) from 116.7 +/- 22.5 to 82.7 +/- 16.6 mg/dL (p < 0.05) and TG from 200.3 +/- 109.2 to 97.0 +/- 45.2 mg/dL (p < 0.001). In addition, there were significant decreases in elevated serum very-low-density lipoprotein cholesterol (VLDL-C) from 47.8 +/- 18.4 to 28.6 +/- 9.5 mg/dL (p < 0.001) and LDL2 cholesterol (LDL2-C) from 20.8 +/- 8.2 to 5.7 +/- 1.8 mg/dL (p < 0.001).


CONCLUSIONS
The results indicate that 4-yr treatment of simvastatin improves profiles of the atherogenic lipids in renal transplant patients with immunosuppressant caused hypercholesterolemia and hypertriglyceridemia treated either cyclosporine or tacrolimus in similar manner.
Imamura
Ryoichi
R
Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Ichimaru
Naotsugu
N
Moriyama
Toshiki
T
Shi
Yi
Y
Namba
Yukiomi
Y
Nonomura
Norio
N
Matsumiya
Kiyomi
K
Toki
Kiyohide
K
Takahara
Shiro
S
Okuyama
Akihiko
A
D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use*; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000517:prevention & control*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008055:Lipids / Q000097:blood; D008297:Male; D010865:Pilot Projects; D011379:Prognosis; D019821:Simvastatin / Q000627:therapeutic use*; D016559:Tacrolimus / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
D000960:Hypolipidemic Agents; D007166:Immunosuppressive Agents; D008055:Lipids; D016572:Cyclosporine; D019821:Simvastatin; D016559:Tacrolimus