Dyslipidemia in Kidney Receiver

Abstract

Background Kidney transplantation is the gold standard of treatment in patients with a terminal renal failure. Nevertheless, the main reason for death of recipients, loss of the renal allograft is cardiovascular disease, and disorder of lipid profile remains one of the most significant risk factors and progressing of cardiovascular pathology. Aim We estimated dyslipidemia dynamics before and at various terms after kidney transplantation and we tried to reveal interrelation of disorder of lipid metabolism with renal transplant functioning. Material and Methods The retrospective observational research of the cohort in a uniform group of lipid profile dynamics observation in terms before kidney transplantation and in 6, 12 and 36 months of two hundred liver recipients at the age of 40.18±10.33 years has been conducted. Among those there was 41.5% female patients and 58.5% male patients. The statistical analysis was carried out by means of STATISTICA 10.0 program. The critical significance value while checking statistical hypotheses in this research was accepted equal 0.05. The method of multifactorial logistic regression was applied to search factors associated with a dyslipidemia. Results Level of the general cholesterol before transplantation was 4.34±1.21 mmol/l, in comparison with an initial indicator of the general cholesterol increase in dynamics in 12 and 36 months was 17.5% (р = 0.02), 22.9% (р = 0.03), respectively. The LDL level in the studied cohort of recipients was around 2.36±1.21 mmol, and in 6 months it increased by 12.3% (р = 0.02), in a year for 5.9% (р = 0.21) and 36 months later differed from initial on 14.8 (р = 0.01). In three years after transplantation period LPVP decreased by 12.3% (р = 0.01). In comparison with initial level before transplantation they increased on 8,9% (р = 0,03) и 16,7% (р =0,01) in 12 and 36 months, respectively. The factors associated with dyslipidemia is the age - 1.21-1.7 (р<0.02), diabetes – 1.1-1.5 (р<0.03), the speed of glomerular filtration (kg/sq.m) - 1.23-1.32 (р<0.02), proteinuria (g/l)-1.55-2.1 (р<0.001), the left ventricle myocardium mass index (kg/sq.m)-1.23-1.55 (р <0.03), hemoglobin (g/l)-1.1-1.23 (р<0.04), systolic arterial blood pressure-1.2-2.1 (р<0.001), diastolic arterial blood pressure – 1.1-2.2 (р<0.002). The negative correlational interrelation between the level of cholesterol and survival of the renal allograft, estimated on the speed of glomerular filtration was revealed (р = 0.003). Level of the general cholesterol was a significant independent predictor for survival and functioning of the renal allotransplantat in 3 years after transplantation. Conclusion The progressing disorder of a lipid profile in the long-term post-transplantation period was revealed, dyslipidemia is a significant modified predictor of successful kidney transplantation.