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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR  
Year : 2011  |  Volume : 22  |  Issue : 2  |  Page : 339-340
Hyperlipidemia in children with normal allograft function


1 Shiraz Nephro-Urology Research Center, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
2 Shiraz Nephro-Urology Research Center, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz; Pediatric Nephrology Division, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
3 Pediatric Nephrology Division, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
4 Shiraz Organ Transplant Center, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

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Date of Web Publication18-Mar-2011
 

How to cite this article:
Derakhshan N, Derakhshan D, Derakhshan A, Hashemi G, Fallahzadeh MH, Basiratnia M, Bazargani Z, Jalaeian H, Malek-Hosseini SA. Hyperlipidemia in children with normal allograft function. Saudi J Kidney Dis Transpl 2011;22:339-40

How to cite this URL:
Derakhshan N, Derakhshan D, Derakhshan A, Hashemi G, Fallahzadeh MH, Basiratnia M, Bazargani Z, Jalaeian H, Malek-Hosseini SA. Hyperlipidemia in children with normal allograft function. Saudi J Kidney Dis Transpl [serial online] 2011 [cited 2020 Jun 6];22:339-40. Available from: http://www.sjkdt.org/text.asp?2011/22/2/339/77627
To the Editor,

Hyperlipidemia is a very common disorder associated with all types of solid organ trans­plantation both in adults and children, [1],[2],[3] and it may increase the severity and hasten the prog­ression of chronic allograft nephropathy, the leading cause of graft loss. [4],[5] The reported pre­valence of dyslipidemia in renal transplant pa­tients is around 60-70% in different series in adults. [2],[4] The pathogenesis of changes in lipid pattern in transplant patients is not clearly un­derstood though it appears to be multifactorial. Some of the important contributing factors include preexisting hyperlipidemia, medications, male gender and allograft dysfunction. [6],[7] During a three month period, in a cross sec­tional design, 12 hour fasting serum Triglyce­ride (TG) and Total Cholesterol (TC) levels were studied among 71 cases of pediatric renal trans­plant recipients, aged 3-18 years at transplantation, with normal graft function at least 7 months after transplantation. For 58 of patients measured data were compared with available age and sex standard values [8] and for those >19 years we compared them with adult standards. [9] Pearson Correlation test was performed for se­rum TC and TG percentiles and other variables including age, height percentile, body mass in­dex percentile, cyclosporine dose (mg/kg/d), creatinine, glomerular filtration rate (GFR) and uric acid and Cyclosporine levels (C 0 and C 2 ) in 58 of patients.

Demographic data and serum TC and TG are summarized in [Table 1]. Sources of donor were living-related (n=24, 33.8%), living-unrelated (n=13, 18.3%) and deceased (n=34, 47.9%). Sixty-nine (97.1%) patients were on triple im­munosuppressive therapy (cyclosporine + pred­nisolone + cellcept or azathioprine), one was on double therapy (cyclosporine + prednisolone) and one did not use any medication. The mean GFR was 86.5 ± 20, uric acid 5.6 ± 1.4, C0 116 ± 56 ng/mL and C2 517 ± 201 ng/mL. TG and cholesterol levels were not statistically different among males and females (P> 0.05). TG per­centiles correlated with age of the patients in the whole group (r=-0.34, P< 0.05), while TC percentiles did not have any correlation with age (P> 0.05).
Table 1: Demographic data and serum lipid profile.

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There was also strong correlation between TG and TC levels in whole group (r=0.3, P< 0.05). No correlation was found between TG and TC percentiles and age at transplantation, years after transplantation, C2 level, GFR and uric acid (P> 0.05).

Our study revealed that prevalence of hyper­triglyceridemia (55%) is more than hyper­cholesterolemia (26.7%), which is in agreement with previous studies. [10] Furthermore, we found a significant correlation between TG and TC percentiles and C 0 level as found by others. [6]

In pediatric renal transplant patients, after the use of general measures such as dietary choles­terol restriction, exercise, alcohol restriction and smoking cessation, pharmacological treatment is usually indicated to control the atherogenic lipid profile of the patient. The effect of pra­vastatin as a lipid-lowering agent following pe­diatric kidney transplantation has been demons­ trated by previous reports. [10],[11]

Hypertriglyceridemia is more common in our pediatric transplant population than hypercho­lesterolemia despite acceptable allograft func­tion, which warrants specific consideration and pharmacological treatment.

 
   References Top

1.Ballantyne CM, Radovancevic B, Farmer JA, et al. Hyperlipidemia after heart transplantation: report of a 6-year experience, with treatment recommendations. J Am Coll Cardiol 1992;19: 1315-21.  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.Aakhus A, Dahl K, Wideroe TE. Hyperlipidemia in renal transplant patients. J Intern Med 1996; 239:177-80.  Back to cited text no. 2
    
3.Siirtola A, Antikainen M, Ala-Houhala M, et al. Serum lipids in children 3 to 5 years after kid­ney, liver, and heart transplantation. Transpl Int 2004;17:109-19.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.Bumgardner GL, Wilson GA, Tso PL, et al. Im­pact of serum lipids on long-term graft and pa­tient survival after renal transplantation. Trans­plantation 1995;60:1418-21.  Back to cited text no. 4
    
5.Castillo D, Cruzado J, Diaz J, et al. The effects of hyperlipidaemia on graft and patient outcome in renal transplantation. Nephrol Dial Transplant 2004;19:67-71.  Back to cited text no. 5
    
6.Hricik DE, Mayes JT, Schulak JA. Independent effects of cyclosporine and prednisone on post­transplant hypercholesterolemia. Am J Kidney Dis 1991;18:353-8.  Back to cited text no. 6
[PUBMED]    
7.Silverstein DM, Palmer J, Polinsky MS, Braas C, Conley SB, Baluarte HJ. Risk factors for hy­perlipidemia in long-term pediatric renal trans­plant recipients. Pediatr Nephrol 2000;14:105-10.  Back to cited text no. 7
[PUBMED]  [FULLTEXT]  
8.Andrew M, Tershakovec AM, Rader DJ. In Nelson text book of pediatrics. P448(table)75-4  Back to cited text no. 8
    
9.Third report of the National Cholesterol Edu­cation Program (NCEP) Expert Panel on detec­tion, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Circulation 2002;106:3143.  Back to cited text no. 9
    
10.Sharma AK, Myers TA, Hunninghake DB, Matas AJ, Kashtan CE. Hyperlipidemia in long­term survivors of pediatric renal transplantation. Clin Transplant 1994;8:252-7.  Back to cited text no. 10
[PUBMED]    
11.Butani L Prospective monitoring of lipid pro­files in children receiving pravastatin preemp­tively after renal transplantation. Pediatr Trans­plant 2005;9:746-5.  Back to cited text no. 11
    

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Correspondence Address:
Nima Derakhshan
Shiraz Nephro-Urology Research Center, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz
Iran
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PMID: 21422639

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