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Dyslipidemia after pediatric renal transplantation—The impact of immunosuppressive regimens
Author(s) -
Habbig Sandra,
Volland Ruth,
Krupka Kai,
Querfeld Uwe,
Dello Strologo Luca,
Noyan Aytül,
Yalcinkaya Fatos,
Topaloglu Rezan,
Webb Nicholas J. A.,
Kemper Markus J.,
Pape Lars,
Bald Martin,
Kranz Birgitta,
Taylan Christina,
Höcker Britta,
Tönshoff Burkhard,
Weber Lutz T.
Publication year - 2017
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12914
Subject(s) - medicine , dyslipidemia , transplantation , renal function , regimen , tacrolimus , obesity
Dyslipidemia contributes to cardiovascular morbidity and mortality in pediatric transplant recipients. Data on prevalence and risk factors in pediatric cohorts are, however, scarce. We therefore determined the prevalence of dyslipidemia in 386 pediatric renal transplant recipients enrolled in the CERTAIN registry. Data were obtained before and during the first year after RT x to analyze possible non‐modifiable and modifiable risk factors. The prevalence of dyslipidemia was 95% before engraftment and 88% at 1 year post‐transplant. Low estimated glomerular filtration rate at 1 year post‐transplant was associated with elevated serum triglyceride levels. The use of TAC and of MPA was associated with significantly lower concentrations of all lipid parameters compared to regimens containing CsA and mTOR i. Immunosuppressive regimens consisting of CsA, MPA , and steroids as well as of CsA, mTOR i, and steroids were associated with a three‐ and 25‐fold ( P <.001) increased risk of having more than one pathologic lipid parameter as compared to the use of TAC , MPA , and steroids. Thus, amelioration of the cardiovascular risk profile after pediatric RT x may be attained by adaption of the immunosuppressive regimen according to the individual risk profile.