Hyperlipidaemia in renal transplantation—risk factor for long-term graft outcome

Abstract. The role of hyperlipidaemia for the outcome of renal transplantation was evaluated in a prospective study involving 151 patients. Graft losses were associated with more pronounced pre-transplant lipid abnormalities. An increased risk of graft loss during the first two post-transplant years was found in patients with marked pre-transplant hypercholestero-laemia (≥6.9 mmol L^-1, P = 0.014; relative risk 2.2). Hypercholesterolaemia ≥6.9mmol L^-1 at 6 months after transplantation, present in 41/115 patients, was associated with a lower GFR ( P = 0.007) and more pronounced albuminuria ( P = 0.009) at 2 years. In patients with graft dysfunction (serum creatinine >160μmol L^-1) at 2 years, more pronounced lipid abnormalities before and at 6 months after transplantation were found. Between 6 months and 2 years, total and LDL cholesterol did not change significantly, but HDL cholesterol decreased ( P = 0.03). In conclusion, hyperlipidaemia is also a risk factor for the long-term outcome in renal transplantation. Further investigations are needed to determine whether graft losses and late graft failure can be prevented or ameliorated by treating hyperlipidaemia in renal transplantation.