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| Year : 2011 | Volume
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| Issue : 2 | Page : 339-340 |
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| Hyperlipidemia in children with normal allograft function |
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Nima Derakhshan1, Dorna Derakhshan1, Ali Derakhshan2, Ghamar Hashemi3, Mohammad Hossein Fallahzadeh2, Mitra Basiratnia3, Zahra Bazargani3, Hamed Jalaeian4, Seyed Ali Malek-Hosseini4
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 Publication | 18-Mar-2011 |
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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 2021 Jan 17];22:339-40. Available from: https://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).
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 | |  |
| 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. 
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| 2. | Aakhus A, Dahl K, Wideroe TE. Hyperlipidemia in renal transplant patients. J Intern Med 1996; 239:177-80.
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| 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.
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| 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.
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| 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.
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| 6. | Hricik DE, Mayes JT, Schulak JA. Independent effects of cyclosporine and prednisone on posttransplant hypercholesterolemia. Am J Kidney Dis 1991;18:353-8.
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| 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.
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| 8. | Andrew M, Tershakovec AM, Rader DJ. In Nelson text book of pediatrics. P448(table)75-4
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| 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.
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| 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.
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| 11. | Butani L Prospective monitoring of lipid profiles in children receiving pravastatin preemptively after renal transplantation. Pediatr Transplant 2005;9:746-5.
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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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