title: Dyslipidemia after pediatric renal transplantation-The impact of immunosuppressive regimens.
abstract: Dyslipidemia contributes to cardiovascular morbidity and mortality in pediatric transplant recipients. Data on prevalence and risk factors in pediatric cohorts are, however, scarce. We therefore determined the prevalence of dyslipidemia in 386 pediatric renal transplant recipients enrolled in the CERTAIN registry. Data were obtained before and during the first year after RTx to analyze possible non-modifiable and modifiable risk factors. The prevalence of dyslipidemia was 95% before engraftment and 88% at 1 year post-transplant. Low estimated glomerular filtration rate at 1 year post-transplant was associated with elevated serum triglyceride levels. The use of TAC and of MPA was associated with significantly lower concentrations of all lipid parameters compared to regimens containing CsA and mTORi. Immunosuppressive regimens consisting of CsA, MPA, and steroids as well as of CsA, mTORi, and steroids were associated with a three- and 25-fold (P<.001) increased risk of having more than one pathologic lipid parameter as compared to the use of TAC, MPA, and steroids. Thus, amelioration of the cardiovascular risk profile after pediatric RTx may be attained by adaption of the immunosuppressive regimen according to the individual risk profile.
authors.affiliation: Division of Pediatric Nephrology, University Children's and Adolescent's Hospital, Cologne, Germany.
authors.forename: Sandra
authors.identifier: http://orcid.org/0000-0002-6511-5023
authors.initials: S
authors.lastname: Habbig
authors.affiliation: Division of Pediatric Oncology and Hematology, University Children's and Adolescent's Hospital, Cologne, Germany.
authors.forename: Ruth
authors.initials: R
authors.lastname: Volland
authors.affiliation: Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Krupka
authors.affiliation: Pediatric Nephrology Charité, University Children's Hospital Berlin, Berlin, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Querfeld
authors.affiliation: Nephrology Unit Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Dello Strologo
authors.affiliation: Department of Pediatric Nephrology, Adana Teaching and Research Center, Baskent University, Adana, Turkey.
authors.forename: Aytül
authors.initials: A
authors.lastname: Noyan
authors.affiliation: Department of Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Fatos
authors.initials: F
authors.lastname: Yalcinkaya
authors.affiliation: Department of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Rezan
authors.initials: R
authors.lastname: Topaloglu
authors.affiliation: Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Center, Manchester, UK.
authors.forename: Nicholas J A
authors.initials: NJ
authors.lastname: Webb
authors.affiliation: University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Pediatric Asklepios Hospital Nord-Heidberg, Hamburg, Germany.
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Kemper
authors.affiliation: Department of Pediatric Nephrology, Hannover Medical School, Hannover, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Pape
authors.affiliation: Clinic of Stuttgart, Olga Children's Hospital, Stuttgart, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bald
authors.affiliation: Department of General Pediatrics, Pediatric Nephrology, University Children's Hospital Muenster, Münster, Germany.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Kranz
authors.affiliation: Division of Pediatric Nephrology, University Children's and Adolescent's Hospital, Cologne, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Taylan
authors.affiliation: Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany.
authors.forename: Britta
authors.initials: B
authors.lastname: Höcker
authors.affiliation: Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Tönshoff
authors.affiliation: Division of Pediatric Nephrology, University Children's and Adolescent's Hospital, Cologne, Germany.
authors.forename: Lutz T
authors.initials: LT
authors.lastname: Weber
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008055:Lipids / Q000097:blood; D008297:Male; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D008055:Lipids; D013256:Steroids; D014280:Triglycerides
keywords: calcineurin inhibitor; cardiovascular disease; hypercholesterolemia; hypertriglyceridemia; mTOR-inhibitor; mycophenolate mofetil