Post transplant hypercholesterolemia following kidney transplant increases risk for cardiovascular disease and effects mortality and morbidity of transplant patients. The immunosuppressive medication regimen appears to be the major factor contributing to hypercholesterolemia post transplant. Balancing the chance of kidney transplant rejection and immunosuppressive side effects is the main challenge in transplantation today. This analysis was to evaluate the incidence of, and risk factors for, developing hypercholesterolemia, and the resultant graft patient survival outcome. Retrospective analysis of 1718 kidney transplant patients at our Center from Jan. 1996 to December 2002 was performed. Patients were divided into Group I (cholesterol >240 mg/dL) and Group II (cholesterol <240 mg/dL). Univariate analysis between the groups showed no statistical differences with regard to donor age, BMI, PRA, mismatch, CIT, cadaveric or living donor, cyclosporine or FK level. However, mean age, males, and glucose levels were higher in the non- hypercholesterolemic group (p=0.007, 0.001, 0.006 respectively). The incidence of hypercholesterolemia in our patients was 16% at baseline, 32% at one year, and decreased to 21% at the last follow-up. There was no significant correlation between post transplant hypercholesterolemia and recipient age, transplant no., or tacrolimus.. However, there was strong correlation between hypercholesterolemia and gender (female) (p=0.001), pre-tx. Diabetes (p=0.01), cyclosporine (0.003), rapamune (0.0001), transplanted kidney vs. other transplanted organ (p=0.03) SrC (p=0.0001).
The prevalence of post-transplant hypercholesterolemia at our Center remains high at 21%. Hypercholesterolemia is a very high risk factor contributing to both graft and patient loss. More attention should be given to this condition adequately adjusting the immunosuppressive medication regimen, treating it aggressively and controlling the hypercholesterolemia.