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      Does Immunosuppressive Regimen Influence the Lipid Disturbances in Kidney Recipients?

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          Though it is said that some immunosuppressive agents are implicated in the development of hyperlipidemia in kidney recipients, this subject is still controversial. Main plasma lipid parameters, as well as apolipoproteins A1 and B were measured periodically in 39 kidney first cadaveric, nondiabetic recipients during 24 months of clinic follow-up after transplantation. Standard triple immunosuppressive therapy: prednisone + cyclosporine + azathioprine was administrated from the beginning. After the second year of kidney transplantation, a significant reduction refers to values of TC, LDL, apo A1 and apo B. In the group with antirejection - methylprednisolone therapy, and without it only TG in the 24th month and apo B in the 1st month were statistically lower in the latter group (both p < 0.05). In the multiple regression test, a linear coincidence was observed between apo A1, apo B and prednisone cumulative dosage after the 1st month, TG and cyclosporine in the 6th month and LDL and cyclosporine in the 12th month after transplantation. It appears that steroids had an impact on lipids directly after transplantation, while cyclosporine did so thereafter.

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          Risk factors for accelerated atherosclerosis in renal transplant recipients.

          The factors responsible for atherosclerosis in renal transplant recipients are not known. In the present study, cardiovascular disease was investigated in 403 patients who received 464 kidney transplants during a 10-year period. Among those who had no clinical evidence of vascular disease at the time of transplantation, atherosclerotic complications developed in 15.8 percent during the post-transplant follow-up period (46.1 +/- 36.2 months). Pre- and post-transplant vascular diseases were closely linked. However, after taking pre-transplant vascular disease into account, multivariate analysis showed that a number of known risk factors (age, sex, diabetes, cigarette smoking, hypertension, and serum cholesterol) were independently associated with post-transplant vascular disease. In addition, the number of acute rejection episodes (all treated with high doses of corticosteroids) was also independently linked to vascular disease. These results suggest that an increased prevalence of known risk factors, and events linked to allograft rejection, explain the high incidence of cardiovascular disease in renal transplant recipients.
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            Hyperlipidemia in adult, pediatric and diabetic renal transplant recipients


              Author and article information

              Am J Nephrol
              American Journal of Nephrology
              S. Karger AG
              October 2000
              15 November 2000
              : 20
              : 5
              : 385-390
              Department of Nephrology, Medical University, Gdańsk, Poland
              13623 Am J Nephrol 2000;20:385–390
              © 2000 S. Karger AG, Basel

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              Page count
              Tables: 2, References: 23, Pages: 6
              Self URI (application/pdf):
              Clinical Study

              Cardiovascular Medicine, Nephrology

              Lipids, Kidney transplantation, Cyclosporine, Prednisone


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