Hyperlipidemia in pediatric kidney transplant recipients treated with cyclosporine
Hyperlipidemia in pediatric kidney transplant recipients treated with cyclosporine
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DOI：
10.1007/s00467-003-1136-y
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发表时间：
2003-06-01
影响因子：
3
通讯作者：
Gillingham, KJ
中科院分区：
文献类型：
--
作者：
Chavers, BM;Hårdstedt, M;Gillingham, KJ
高脂血症是成人肾移植(TX)受者心血管疾病的危险因素。我们试图确定接受环孢素A(CsA)治疗的儿童肾TX患者中高脂血症的患病率及其相关的危险因素。我们确定了在1991年1月1日至1993年12月31日期间移植的59名患者(平均年龄8.2+/-5.7岁)。TX前，34%的患者总胆固醇升高[TC>；200 mg/dl(5.17 mmol/L)]；54%的患者甘油三酯升高[TG>；200 mg/dl(2.26 mmol/L)]。透析(非透析)患者Tx前平均甘油三酯(TG)分别为306 mg/dl(3.46 mmoL/L)和228 mg/dl(2.58 mmoL/L)(P=0.04)。腹膜透析组TC均值为2 2 2 mg/dl(5.74 mm ol/dl)，高于血液透析组(16 9 mg/dl)(4.37 mm ol/L)(P=0.0 3)。TX前和3年相关(TC，r=0.49，P=0.0008；TG，r=0.41，P=0.001)；3年和5年TC相关(r=0.57，P=0.003)。在TX后5年，41%的受者TC升高；14%的受者TG升高。TC升高的受者在TX后1年的平均CsA浓度较高(P=0.03)。甘油三酯升高的受者倾向于接受更多的泼尼松治疗(P=0.06)。在TX后5年，受者高脂血症的发生率很高。高脂血症的识别和治疗应包括在儿童肾脏TX方案中。
Hyperlipidemia is a risk factor for cardiovascular disease in adult kidney transplant (Tx) recipients. We sought to determine the prevalence of, and the risk factors associated with, hyperlipidemia in pediatric kidney Tx recipients on cyclosporine (CsA). We identified 59 patients (mean age 8.2+/-5.7 years) transplanted between 1 January 1991 and 31 December 1993. Pre Tx, 34% had elevated total cholesterol [TC>200 mg/dl (5.17 mmol/l)]; 54% had elevated triglycerides [TG>200 mg/dl (2.26 mmol/L)]. Mean TG was higher pre Tx in dialysis (versus nondialysis) patients: 306 mg/dl (3.46 mmol/l) versus 228 mg/dl (2.58 mmol/l) (P=0.04). Mean TC was higher in peritoneal dialysis than hemodialysis patients: 222 mg/dl (5.74 mmol/l) versus 169 mg/dl (4.37 mmol/l) (P=0.03). Pre Tx and 3-year values correlated (TC, r=0.49, P=0.0008; TG, r=0.41, P=0.001); 3- and 5-year TC values correlated (r=0.57, P=0.003). At 5 years post Tx, 41% of the recipients had elevated TC; 14% had elevated TG. Recipients with elevated TC had higher mean CsA concentrations at 1 year post Tx (P=0.03). Recipients with elevated TG tended to receive more prednisone (P=0.06). At 5 years post Tx, recipients had a high prevalence of hyperlipidemia. The identification and treatment of hyperlipidemia should be included in pediatric kidney Tx protocols.