Chronic allograft nephropathy (CAN) is now the leading cause of renal transplant loss in pediatric transplant recipients. Despite improvements in immunosuppression, which have significantly reduced the incidence of acute rejection, the rates of chronic kidney loss have remained unchanged in pediatric transplant patients over the last 20 years. Hyperlipidemia is known a risk factor for cardiovascular disease and chronic allograft nephropathy in adult renal transplant recipients, whereas no data exist in pediatric transplant population. In this cross sectional study, 62 renal transplant recipients (32 CAN vs. 30 non-CAN) that aged 5-18 year(yr) and with the mean follow-up time of 48 month(mo) (9-93 mo) after transplantation, were evaluated for lipid profile and renal function tests. The incidence of hypertriglyceridemia and hypercholesterolemia after Tx in non-CAN group was 53.3% and 26.7%, respectively. On the other hand, the incidence of hypertriglyceridemia and hypercholesterolemia after Tx in CAN transplanted children was 68.8% and 59.4%, respectively and the result of McNemar test show that only hypercholesterolemia was significantly more occurred after Tx among CAN patients (59.4% vs. 26.3%, P = 0.021). Comparisons Between groups also showed that hypercholesterolemia and high LDL cholesterol were significantly more seen in CAN group (59.4% vs. 26.7%, P = 0.019; and, 57.1% vs. 22.2%, P = 0.039, respectively). Thus, hypercholesterolemia and high LDL cholesterol were indicated as significant risk factors for CAN [OR = 4.02 (95%CI, 1.37-11.76) and OR=4.67 (95%CI, 1.16-18.81), respectively]. Further analysis with Cochran's statistics show that the effect of hypercholesterolemia on CAN is also independent of acute rejection (P=0.024), hypertension (P=0.011) and donor age (P=0.017). Our results showed that in pediatric recipients hyperlipidemia and particularly hypercholesterolemia have significant association with chronic allograft nephropathy and as adults may need specific therapy which could be more evaluated in later studies.
Volume : 6
Issue : 4
Pages : 136
Department of Nephrology, Abuzar Pediatric Hospital, Jundishapour University of Medical Sciences, Ahvaz, Iran