Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/34247 http://dx.doi.org/10.1016/j.transproceed.2011.08.074 |
Resumo: | Aim. This study analyzed the incidence, time course, and risk factors associated with dyslipidemia during the first year after kidney transplantation among patients receiving various immunosuppressive regimens.Methods. the analysis included 474 kidney transplant recipients receiving cyclosporine (CSA) combined with sirolimus (SRL; n = 137) or mycophenolate (MMF, n = 58) or everolimus (EVR, n = 47); or SRL combined with MMF (n = 32); or tacrolimus (TAC) combined with SRL (n = 86) or MMF (n = 114). All patients received prednisone. We evaluated the influence of demographic features, clinical outcomes, and statin use on lipid profiles during the first year after transplantation. total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, TC:HDL-C, LDL-C:HDL-C, TG:HDL-C.Results. Lipid profiles were within the recommended ranges in 28% of patients pretransplantation and in 10% at 1 year; 27% of them received statins. At 1 year, LDL-C <100 mg/dL was observed in 31.8% of patients but more than 35% of these patients still showed other lipid fractions or ratios outside recommended target concentrations. Among all patients with LDL-C > 100 mg/dL, almost 70% to 80% had other lipid fractions or ratios within target ranges. A logistic regression analysis showed age, gender, time on dialysis, diabetes, type of calcineurin inhibitor (CSA vs TAC), adjunctive therapy (SRL/EVR vs MMF) and prednisone dose to be associated with dyslipidemia.Conclusion. Dyslipidemia is frequent at 1 year after transplantation. the lack of agreement among changes observed in lipid fractions and ratios suggests that more studies are necessary to guide therapy besides targeting LDL-C concentrations as recommended by current guidelines. |
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Spinelli, Glaucio Amaral [UNIFESP]Felipe, Claudia Rosso [UNIFESP]Park, Sung In [UNIFESP]Sampaio, Edison Luiz Mandia [UNIFESP]Tedesco-Silva Junior, Hélio [UNIFESP]Pestana, Jose Osmar Medina [UNIFESP]Universidade Federal de São Paulo (UNIFESP)2016-01-24T14:17:28Z2016-01-24T14:17:28Z2011-12-01Transplantation Proceedings. New York: Elsevier B.V., v. 43, n. 10, p. 3730-3737, 2011.0041-1345http://repositorio.unifesp.br/handle/11600/34247http://dx.doi.org/10.1016/j.transproceed.2011.08.074WOS000298620200030.pdf10.1016/j.transproceed.2011.08.074WOS:000298620200030Aim. This study analyzed the incidence, time course, and risk factors associated with dyslipidemia during the first year after kidney transplantation among patients receiving various immunosuppressive regimens.Methods. the analysis included 474 kidney transplant recipients receiving cyclosporine (CSA) combined with sirolimus (SRL; n = 137) or mycophenolate (MMF, n = 58) or everolimus (EVR, n = 47); or SRL combined with MMF (n = 32); or tacrolimus (TAC) combined with SRL (n = 86) or MMF (n = 114). All patients received prednisone. We evaluated the influence of demographic features, clinical outcomes, and statin use on lipid profiles during the first year after transplantation. total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, TC:HDL-C, LDL-C:HDL-C, TG:HDL-C.Results. Lipid profiles were within the recommended ranges in 28% of patients pretransplantation and in 10% at 1 year; 27% of them received statins. At 1 year, LDL-C <100 mg/dL was observed in 31.8% of patients but more than 35% of these patients still showed other lipid fractions or ratios outside recommended target concentrations. Among all patients with LDL-C > 100 mg/dL, almost 70% to 80% had other lipid fractions or ratios within target ranges. A logistic regression analysis showed age, gender, time on dialysis, diabetes, type of calcineurin inhibitor (CSA vs TAC), adjunctive therapy (SRL/EVR vs MMF) and prednisone dose to be associated with dyslipidemia.Conclusion. Dyslipidemia is frequent at 1 year after transplantation. the lack of agreement among changes observed in lipid fractions and ratios suggests that more studies are necessary to guide therapy besides targeting LDL-C concentrations as recommended by current guidelines.Universidade Federal de São Paulo UNIFESP, Div Nephrol, Hosp Rim & Hipertensao, BR-04038002 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Div Nephrol, Hosp Rim & Hipertensao, BR-04038002 São Paulo, BrazilWeb of Science3730-3737engElsevier B.V.Transplantation Proceedingshttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policyinfo:eu-repo/semantics/openAccessLipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimeninfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlereponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALWOS000298620200030.pdfapplication/pdf628910${dspace.ui.url}/bitstream/11600/34247/1/WOS000298620200030.pdf5b4baafb88e92d0569b70895341bc491MD51open accessTEXTWOS000298620200030.pdf.txtWOS000298620200030.pdf.txtExtracted texttext/plain33677${dspace.ui.url}/bitstream/11600/34247/2/WOS000298620200030.pdf.txt99a80ea74eae9f107283a9e0370d5932MD52open access11600/342472021-10-04 21:22:56.361open accessoai:repositorio.unifesp.br:11600/34247Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652021-10-05T00:22:56Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen |
title |
Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen |
spellingShingle |
Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen Spinelli, Glaucio Amaral [UNIFESP] |
title_short |
Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen |
title_full |
Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen |
title_fullStr |
Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen |
title_full_unstemmed |
Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen |
title_sort |
Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen |
author |
Spinelli, Glaucio Amaral [UNIFESP] |
author_facet |
Spinelli, Glaucio Amaral [UNIFESP] Felipe, Claudia Rosso [UNIFESP] Park, Sung In [UNIFESP] Sampaio, Edison Luiz Mandia [UNIFESP] Tedesco-Silva Junior, Hélio [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] |
author_role |
author |
author2 |
Felipe, Claudia Rosso [UNIFESP] Park, Sung In [UNIFESP] Sampaio, Edison Luiz Mandia [UNIFESP] Tedesco-Silva Junior, Hélio [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] |
author2_role |
author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Spinelli, Glaucio Amaral [UNIFESP] Felipe, Claudia Rosso [UNIFESP] Park, Sung In [UNIFESP] Sampaio, Edison Luiz Mandia [UNIFESP] Tedesco-Silva Junior, Hélio [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] |
description |
Aim. This study analyzed the incidence, time course, and risk factors associated with dyslipidemia during the first year after kidney transplantation among patients receiving various immunosuppressive regimens.Methods. the analysis included 474 kidney transplant recipients receiving cyclosporine (CSA) combined with sirolimus (SRL; n = 137) or mycophenolate (MMF, n = 58) or everolimus (EVR, n = 47); or SRL combined with MMF (n = 32); or tacrolimus (TAC) combined with SRL (n = 86) or MMF (n = 114). All patients received prednisone. We evaluated the influence of demographic features, clinical outcomes, and statin use on lipid profiles during the first year after transplantation. total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, TC:HDL-C, LDL-C:HDL-C, TG:HDL-C.Results. Lipid profiles were within the recommended ranges in 28% of patients pretransplantation and in 10% at 1 year; 27% of them received statins. At 1 year, LDL-C <100 mg/dL was observed in 31.8% of patients but more than 35% of these patients still showed other lipid fractions or ratios outside recommended target concentrations. Among all patients with LDL-C > 100 mg/dL, almost 70% to 80% had other lipid fractions or ratios within target ranges. A logistic regression analysis showed age, gender, time on dialysis, diabetes, type of calcineurin inhibitor (CSA vs TAC), adjunctive therapy (SRL/EVR vs MMF) and prednisone dose to be associated with dyslipidemia.Conclusion. Dyslipidemia is frequent at 1 year after transplantation. the lack of agreement among changes observed in lipid fractions and ratios suggests that more studies are necessary to guide therapy besides targeting LDL-C concentrations as recommended by current guidelines. |
publishDate |
2011 |
dc.date.issued.fl_str_mv |
2011-12-01 |
dc.date.accessioned.fl_str_mv |
2016-01-24T14:17:28Z |
dc.date.available.fl_str_mv |
2016-01-24T14:17:28Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Transplantation Proceedings. New York: Elsevier B.V., v. 43, n. 10, p. 3730-3737, 2011. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/34247 http://dx.doi.org/10.1016/j.transproceed.2011.08.074 |
dc.identifier.issn.none.fl_str_mv |
0041-1345 |
dc.identifier.file.none.fl_str_mv |
WOS000298620200030.pdf |
dc.identifier.doi.none.fl_str_mv |
10.1016/j.transproceed.2011.08.074 |
dc.identifier.wos.none.fl_str_mv |
WOS:000298620200030 |
identifier_str_mv |
Transplantation Proceedings. New York: Elsevier B.V., v. 43, n. 10, p. 3730-3737, 2011. 0041-1345 WOS000298620200030.pdf 10.1016/j.transproceed.2011.08.074 WOS:000298620200030 |
url |
http://repositorio.unifesp.br/handle/11600/34247 http://dx.doi.org/10.1016/j.transproceed.2011.08.074 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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Transplantation Proceedings |
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http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy info:eu-repo/semantics/openAccess |
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http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy |
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openAccess |
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3730-3737 |
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Elsevier B.V. |
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Elsevier B.V. |
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