Should Post Kidney Transplantation Hyperlipidemia Considered a Risk Factor for Graft Function?

Background: Hyperlipidemia is a common problem after kidney transplantation.Objective: To uncover the real impact of post kidney transplantation hyperlipidemia on graft function and survival, and to determine whether it is just a biochemical phenomenon after using immunosuppressant or a part of dise...

Full description

Bibliographic Details
Main Authors: G. Pourmand, A. Saraji, S. Dehgani, A. Mehrsai, M. Nikoobakht, M. Talibnajad, E. Razeghi, M. Rahbar, H. Hosseini, N. Pourmand, Sh. Pourmand, M. Zahedikia, M. Porhussein, F. Heidari
Format: Article
Language:English
Published: Shiraz University of Medical Sciences 2010-07-01
Series:International Journal of Organ Transplantation Medicine
Subjects:
Online Access:http://home.sums.ac.ir/~habibzaf/ojs/index.php/IJOTM/article/view/39/76
_version_ 1828491332134371328
author G. Pourmand
A. Saraji
S. Dehgani
A. Mehrsai
M. Nikoobakht
M. Talibnajad
E. Razeghi
M. Rahbar
H. Hosseini
N. Pourmand
Sh. Pourmand
M. Zahedikia
M. Porhussein
F. Heidari
author_facet G. Pourmand
A. Saraji
S. Dehgani
A. Mehrsai
M. Nikoobakht
M. Talibnajad
E. Razeghi
M. Rahbar
H. Hosseini
N. Pourmand
Sh. Pourmand
M. Zahedikia
M. Porhussein
F. Heidari
author_sort G. Pourmand
collection DOAJ
description Background: Hyperlipidemia is a common problem after kidney transplantation.Objective: To uncover the real impact of post kidney transplantation hyperlipidemia on graft function and survival, and to determine whether it is just a biochemical phenomenon after using immunosuppressant or a part of disease pathology.Methods: 330 kidney transplants were managed in Sina Hospital Kidney Transplantation Unit affiliated to Tehran University of Medical Sciences, Tehran, Iran from September 1994 till February 2010. The demographiccharacteristics of the patients, causes of chronic kidney diseases, history of pretransplantation dialysis, pretransplantation comorbidities (e.g., hypertension, diabetes mellitus [DM], hyperlipidemia and coronary artery disease), rejection episodes, status of infection with cytomegalous virus [CMV], post-transplantationDM, hyperlipidemia, ischemic heart disease [IHD], and graft and patient survival were recorded. A serum creatinine level >2 mg/dL was considered as “graft deterioration,” and return to dialysis as “graft loss.” According to the presence or absence of post kidney transplantation hypercholesterolemia (>200 mg/dL) or hypertriglyceridemia (>200 mg/dL), the patients were classified into “hyperlipidemic” or “non-hyperlipidemic.”The presence of clinical or paraclinical coronary artery disease was also determined in both groups.Results: The incidence of hyperlipidemia elevated from 8% to 50% before and after transplantation. 2.7% developed clinical IHD. 13% of hyperlipidemics and 22% of non-hyperlipidemics developed graft deterioration.Among hyperlipidemics with deteriorated grafts 40% had premorbid diseases, 68% had CMV infectionand 82% had hypertension. Only 22% had previous acute rejection and 27% received deceased kidney transplant.Conclusions: post kidney transplantation hyperlipidemia is just an associated phenomenon secondary to the use of immunosuppressant medications, which have no obvious impact on renal graft function and can be easily controlled by instituting dietary modifications and use of modern antilipid medications. Post kidneytransplantation CMV infection and hypertension are considered as the main threatening risk for renal graft—even more dangerous than acute or chronic rejections.
first_indexed 2024-12-11T11:00:28Z
format Article
id doaj.art-23c6bf8c787b455f91cf538151c3cc59
institution Directory Open Access Journal
issn 2008-6490
2008-6482
language English
last_indexed 2024-12-11T11:00:28Z
publishDate 2010-07-01
publisher Shiraz University of Medical Sciences
record_format Article
series International Journal of Organ Transplantation Medicine
spelling doaj.art-23c6bf8c787b455f91cf538151c3cc592022-12-22T01:09:54ZengShiraz University of Medical SciencesInternational Journal of Organ Transplantation Medicine2008-64902008-64822010-07-0113131137Should Post Kidney Transplantation Hyperlipidemia Considered a Risk Factor for Graft Function?G. PourmandA. SarajiS. DehganiA. MehrsaiM. NikoobakhtM. TalibnajadE. RazeghiM. RahbarH. HosseiniN. PourmandSh. PourmandM. ZahedikiaM. PorhusseinF. HeidariBackground: Hyperlipidemia is a common problem after kidney transplantation.Objective: To uncover the real impact of post kidney transplantation hyperlipidemia on graft function and survival, and to determine whether it is just a biochemical phenomenon after using immunosuppressant or a part of disease pathology.Methods: 330 kidney transplants were managed in Sina Hospital Kidney Transplantation Unit affiliated to Tehran University of Medical Sciences, Tehran, Iran from September 1994 till February 2010. The demographiccharacteristics of the patients, causes of chronic kidney diseases, history of pretransplantation dialysis, pretransplantation comorbidities (e.g., hypertension, diabetes mellitus [DM], hyperlipidemia and coronary artery disease), rejection episodes, status of infection with cytomegalous virus [CMV], post-transplantationDM, hyperlipidemia, ischemic heart disease [IHD], and graft and patient survival were recorded. A serum creatinine level >2 mg/dL was considered as “graft deterioration,” and return to dialysis as “graft loss.” According to the presence or absence of post kidney transplantation hypercholesterolemia (>200 mg/dL) or hypertriglyceridemia (>200 mg/dL), the patients were classified into “hyperlipidemic” or “non-hyperlipidemic.”The presence of clinical or paraclinical coronary artery disease was also determined in both groups.Results: The incidence of hyperlipidemia elevated from 8% to 50% before and after transplantation. 2.7% developed clinical IHD. 13% of hyperlipidemics and 22% of non-hyperlipidemics developed graft deterioration.Among hyperlipidemics with deteriorated grafts 40% had premorbid diseases, 68% had CMV infectionand 82% had hypertension. Only 22% had previous acute rejection and 27% received deceased kidney transplant.Conclusions: post kidney transplantation hyperlipidemia is just an associated phenomenon secondary to the use of immunosuppressant medications, which have no obvious impact on renal graft function and can be easily controlled by instituting dietary modifications and use of modern antilipid medications. Post kidneytransplantation CMV infection and hypertension are considered as the main threatening risk for renal graft—even more dangerous than acute or chronic rejections.http://home.sums.ac.ir/~habibzaf/ojs/index.php/IJOTM/article/view/39/76HyperlipidemiaPost kidney transplantationGrafts survival
spellingShingle G. Pourmand
A. Saraji
S. Dehgani
A. Mehrsai
M. Nikoobakht
M. Talibnajad
E. Razeghi
M. Rahbar
H. Hosseini
N. Pourmand
Sh. Pourmand
M. Zahedikia
M. Porhussein
F. Heidari
Should Post Kidney Transplantation Hyperlipidemia Considered a Risk Factor for Graft Function?
International Journal of Organ Transplantation Medicine
Hyperlipidemia
Post kidney transplantation
Grafts survival
title Should Post Kidney Transplantation Hyperlipidemia Considered a Risk Factor for Graft Function?
title_full Should Post Kidney Transplantation Hyperlipidemia Considered a Risk Factor for Graft Function?
title_fullStr Should Post Kidney Transplantation Hyperlipidemia Considered a Risk Factor for Graft Function?
title_full_unstemmed Should Post Kidney Transplantation Hyperlipidemia Considered a Risk Factor for Graft Function?
title_short Should Post Kidney Transplantation Hyperlipidemia Considered a Risk Factor for Graft Function?
title_sort should post kidney transplantation hyperlipidemia considered a risk factor for graft function
topic Hyperlipidemia
Post kidney transplantation
Grafts survival
url http://home.sums.ac.ir/~habibzaf/ojs/index.php/IJOTM/article/view/39/76
work_keys_str_mv AT gpourmand shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT asaraji shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT sdehgani shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT amehrsai shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT mnikoobakht shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT mtalibnajad shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT erazeghi shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT mrahbar shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT hhosseini shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT npourmand shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT shpourmand shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT mzahedikia shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT mporhussein shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction
AT fheidari shouldpostkidneytransplantationhyperlipidemiaconsideredariskfactorforgraftfunction