Renal transplantations are often complicated by cardiovascular diseases. These complications are frequently associated with hyperlipidaemia. However, the reason for the high incidence of cardiovascular disease in renal transplant recipients who have roughly normal concentrations of plasma lipids has to be determined. We measured plasma lipid parameters, HDL and LDL particle size and the fractional esterification rate of cholesterol in plasma depleted of apoB containing apoproteins (FERHDL) in 40 subjects (23 men and 17 women), who underwent successful kidney transplantation 24 or more months before the date of assessment. The patients were selected from a group of renal transplant recipients of the Department of Nephrology (Institute of Clinical and Experimental Medicine, Prague). The criterion for selection was normal pre-transplant plasma HDL cholesterol (HDL-C). Basic plasma lipid parameters (total cholesterol TC, HDL-C, triglycerides (TG), LDL-C were compared at 3 occasions: before kidney transplantation (A), 6 months after transplantation (B) and 24 and more months after transplantation (C). Standard enzymatic methods were applied for estimation TC, TG and gradient gel electrophoresis for determination of lipoproteins particle size. FERHDL was determined using radioassay. In the interval A–B increased significantly: body mass index BMI (from 23.4±3.8 to 25.7±4.0, p < 0.001), TC levels (from 5.4±1.3 to 6.6±1.3 mmol/L, p < 0.001) and TG (from 1.7±0.7 to 2.4±1.2 mmol/L, p < 0.001). HDL and LDL cholesterol remained unchanged. In interval B–C we observed a significant decrease of plasma TC (from 6.6±1.3 to 5:8±1.2 mmol/L, p < 0.002), TG (from 2.36±1.2 to 1.4±0.7 mmol/L, p < 0.001) and HDL-C (from 1.67±0.38 to 1.17±0.25,p < 0.0001). No changes in LDL-C and BMI were noticed in the B,C interval. The atherogenic index of plasma despite of significant differences in TG and HDL-C concentrations remained without change. The size of HDL and FERHDL values measured 24 and more months after transplantation were not different from those in control subjects. However, LDL particle size was within the range of the atherogenic B plasma type in 33 out of 40 subjects. Correlation analysis showed abnormalities in relations between LDL sizes, TG and FE RHDL. In healthy subjects there is a very close correlation between FERHDL and TG levels and inverse correlation between and LDL size. In renal transplant recipients only the correlation between FERHDL and HDL-C was significant (R = -0.67, p < 0.001).

        Key words: HDL sub-populations, LDL size, renal transplant recipients, cholesterol esterification rate (FERHDL), cardiovascular disease.