Abstrakt
Hyperlipidemia after renal transplantation is one of the most common long-term metabolic complications, markedly raising the risk for the development of athero-sclerotic lesions. As a result, it contributes to the high incidence of cardiovascular disease after transplantation and, presumably, has an effect on the progression of chronic rejection.
The long-term survival of transplant recipients and the increase in their mean age post-transplant entails a rise in the long-term post-transplant risk. A prospective metabolic study was designed to assess 420 kidney transplant recipients for a period of 24 months.
The patients were divided into four groups by age and sex. All patients had clinical, laboratory, and dietetic examinations at 3-month intervals.
During the study, there was a significant increase in the values of lipid spectrum parameters (cholesterol, LDL-cholesterol, triglycerides; p 60 years also showing the highest increase in body mass index (BMI, p < 0.01). The risk for atherogenesis remains high despite a rise in HDL-cholesterol (HDL cholesterol/total cholesterol 0.19 +/- 0.07 to 0.21 +/- 0.05, TG/HDL-cholesterol up to 2.84 +/- 0.34; p < 0.01).
This particular group also showed a significant decrease in creatinine clearance between months 6 and 12 of follow-up. It is evident from our findings that women over the age of 60 years constitute a subpopulation at an increased metabolic risk after renal transplantation.
However, long-term individualized dietetic/pharmacological intervention is a prerequisite for treatment in all patients.