Summary:
Objective: Monitoring of cholesterol and triglyceride levels in patients after kidney transplantation, and their correlation
with morphological findings within the graft, immunosuppressive regimen, and some other clinical and laboratory data.
Design: Clinical Study.
Material and Method: In 91 patients with stabilized graft function and serum creatinine below 280 µmol/l at one year
after transplantation, cholesterol, triglycerides, BMI, and serum creatinine were investigated at the time of transplantation,
and one year and two years after the transplantation. One year after the transplantation, a protocol biopsy was
carried out. The patients were treated with triple-drug immunosuppression cyclosporine-A + prednisone + mycophenolate
mofetil or azathioprine, or with tacrolimus + prednisone + mycophenolate mofetil or azathioprine.
Results: Prevalence of patients with pathological value of cholesterol and/or triglycerides decreased significantly in the
course of follow-up (89%,80%,69%). Prevalence stagnated in cyclosporine-A subgroup, but in tacrolimus subgroup,
a significant decrease was observed. Significantly decreased mean values of triglycerides were in the whole group,
and in subgroup tacrolimus. A majority of patients was treated with hypolipidemics, but the mean values of cholesterol
and triglyceride in treated and untreated patients did not show any significant difference. BMI values had significantly
increasing trend from the time of transplantation. In protocol biopsy, a chronic allograft nehropathy was found in 69% of
patients, but there was no correlation with cholesterol and triglycerides.
Conclusion: In contrast to cyclosporine-A, immunosuppression with tacrolimus was associated with decrease of triglyceridaemia
after kidney transplantation. No correlation between the morphological finding and cholesterol and triglycerides
values was found.
Key words:
cholesterol, triglycerides, protocol biopsy, chronic allograft nephropathy, cyclosporine-A, tacrolimus.