Cardiovascular risk profile in nondiabetic renal transplant patients: cyclosporine versus tacrolimus
| Autor: | Alejandra Alvarez, Armando Torres, José Manuel González-Posada, Victor Lorenzo, F Oppenheimer, V Torregrosa, Alejandro Jiménez, Marian Cobo, Domingo Hernández |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Hyperlipidemias Gastroenterology Tacrolimus Body Mass Index Postoperative Complications Risk Factors Internal medicine Diabetes mellitus Hyperlipidemia medicine Diabetes Mellitus Humans Renal replacement therapy Kidney transplantation Transplantation business.industry Middle Aged medicine.disease Kidney Transplantation Calcineurin Renal Replacement Therapy Endocrinology Cholesterol Cardiovascular Diseases Hypertension Cyclosporine Surgery Female business Body mass index Dyslipidemia Immunosuppressive Agents |
| Zdroj: | Transplantation proceedings. 35(5) |
| ISSN: | 0041-1345 |
| Popis: | Calcineurin inhibitors (CIs) contribute to cardiovascular risk (CR) in renal transplant (RT) patients. However, the CR profile in RT patients without preexistent diabetes is not well known. We compared CR factors in 191 nondiabetic RT recipients with functioning grafts beyond 1 year, receivingly either CsA (Neoral; n=100) or tacrolimus (Tac; n= 91). Clinical data and pretransplant CR profiles were similar in both groups. There were no differences in acute rejection episodes and graft survival rates during follow-up. The overall proportions of posttransplant diabetes (9% versus 6%), and of hypertension (73% vs 63%) were similar in both groups. Hyperlipidemia was more frequent in the CsA group (58% vs 31%; P=.0001). The cholesterol levels in the CsA group showed at 3 months (232+/-47 vs 202+/-42 m/dL; P=.0001), 6 months (232+/-49 vs 205+/-41 mg/dL; P=.0001), and 12 months (217+/-50 vs 202+/-40 mg/dL; P=.028), despite receiving a greater proportion of lipid-lowering drugs (49% vs 15%; P=.0001). Logistic regression analysis showed that CsA was an independent predictor of posttransplant hyperlipidemia (OR: 5.8, CI 95%; 3.3-10.7; P=.0001) as were age, female gender, pretransplant dyslipidemia, and body mass index (BMI). Interestingly, an interaction was observed between pretransplant BMI and CIs: Among pretransplant normal weight patients (BMI25 kg/m2), CsA produced a greater incidence of hyperlipidemia than tacrolimus (58% vs 23%; P=.0001) while not among patients who were overweight (BMI25 kg/m2: pretransplant 58% vs 42%; P=.341). In conclusion, CsA confers a higher risk of hyperlipidemia after RT in nondiabetic patients, particularly those with normal pretransplant weight. |
| Databáze: | OpenAIRE |
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