Effects of cyclosporine-tacrolimus switching in posttransplantation hyperlipidemia on high-density lipoprotein 2/3, lipoprotein a1/b, and other lipid parameters.
OBJECTIVE
In renal transplant recipients, cyclosporine treatment appears to cause more frequent hyperlipidemia than tacrolimus usage. In this study, hyperlipidemic renal transplant recipients who use cyclosporine were investigated for changes in high-density lipoprotein (HDL)-2/3, apolipoprotein (Apo) A1/B, other lipid and biochemical parameters, and body mass index after prospective cyclosporine to tacrolimus switching.


METHODS
Fifteen patients, including 9 females of overall mean age of 33.2 +/- 10.7 years and posttransplantation time of 78.06 +/- 42.93 months with a mean body mass index of 23.77 +/- 3.34 kg/m(2), were included if they were nondiabetic, hyperlipidemic, and had undergone renal transplantation between 1992 and 2000, using cyclosporine and candidates for a switch to tacrolimus due to hyperlipidemia. Before switching to tacrolimus and at 12 months of tacrolimus use we studied fasting blood samples for creatinine, uric acid, glucose, triglyceride, Apo A1, Apo B, low-density lipoprotein (LDL), HDL2, HDL3, and total cholesterol.


RESULTS
There were no significant differences in creatinine, uric acid, glucose levels, or body mass index before tacrolimus versus 12 months thereafter. It was observed that tacrolimus significantly decreased triglyceride, Apo A1, Apo B, LDL, HDL, and total cholesterol levels (P < .001; P = .006; P = .01; P < .001; P = .03; P </= .001, respectively), but had no effect on homocysteine, Apo A1/B, HDL 2, HDL 3, or HDL 2/3 levels (P > .05).


CONCLUSIONS
Switching from cyclosporine to tacrolimus was associated with a more favorable cardiovascular risk profile by improving hyperlipidemia.
Seymen
P
P
Department of Nephrology/Internal Medicine, Haydarpasa Numune Educational and Research Hospital, Istanbul, Turkey. seymenp@yahoo.com
Yildiz
M
M
Türkmen
M F
MF
Titiz
M I
MI
Seymen
H O
HO
D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000276:immunology / Q000517:prevention & control; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000453:epidemiology*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology* / Q000502:physiology; D008055:Lipids / Q000097:blood*; D017270:Lipoprotein(a) / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology*; D016559:Tacrolimus / Q000627:therapeutic use*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
D007166:Immunosuppressive Agents; D008055:Lipids; D017270:Lipoprotein(a); D008075:Lipoproteins, HDL; D014280:Triglycerides; D006710:Homocysteine; D016572:Cyclosporine; D016559:Tacrolimus