Abstract
Hyperlipidemia is a common problem in solid organ transplant recipients. In this study we evaluated the role of pre-transplant renal replacement therapy on early and late changes of serum lipid levels in children following renal transplantation. In 46 children with chronic renal failure (median age 10.3 years) and 12 children with heart failure (median age 5.0 years), cholesterol and triglycerides were measured before and during follow-up after transplantation. Children with renal failure had significantly higher serum lipids than controls (n=34, median age 9.2 years) and patients with heart failure. Pre transplantation, cholesterol and triglycerides were significantly lower in the hemodialysis than in the peritoneal dialysis population, whereas conservatively treated children had intermediate levels. After transplantation, serum cholesterol converged towards a mean level of 208 mg/dl and triglyceride levels converged towards a uniform level of 195 mg/dl at 9 months post transplant. The ratio of cholesterol/high-density lipoprotein significantly decreased from 4.7 to 3.8. The pattern of "post-transplant hyperlipidemia" was similar in both renal and cardiac allograft recipients. Hence, the early post-transplant changes of serum lipid pattern are markedly dependent on the mode of pre-transplant renal replacement therapy. Later, serum lipid levels were no longer influenced by prior renal replacement therapy and showed a new pattern of "post-transplant hyperlipidemia" in all children.
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Offner G, Latta K, Hoyer PF, Baum HJ, Ehrich JH, Pichlmayr R, Brodehl J (1999) Kidney transplanted children come of age. Kidney Int 55:1509–1517
(1999) Pediatric end-stage renal disease. Am J Kidney Dis 34 [Suppl 1]:S102–S113
Kasiske BL (1998) Hyperlipidemia in patients with chronic renal disease. Am J Kidney Dis 32 [Suppl 3]: S142–S156
Querfeld U (1993) Disturbances of lipid metabolism in children with chronic renal failure. Pediatr Nephrol 7:749–757
Triolo G, Segoloni GP, Salomone M, Piccoli GB, Messina M, Massara C, Bertinet DB, Vercellone A (1990) Comparison between two dialytic populations undergoing renal transplantation. Adv Perit Dial 6:72–75
Misra M, Webb AT, Reaveley DA, Doherty E, O'Donnell M, Seed M, Brown EA (1997) The effect of change of renal replacement therapy on serum lipoprotein (a) concentration. Adv Perit Dial 13:168–173
Singh A, Tejani C, Benfield M, Tejani A (1998) Sequential analysis of the lipid profile of children post-renal transplantation. Pediatr Transplant 2:216–223
Sharma AK, Myers TA, Hunninghake DB, Matas AJ, Kashtan CE (1994) Hyperlipidemia in long-term survivors of pediatric renal transplantation. Clin Transplant 8:252–257
Van Gool S, Van Damme-Lombaerts R, Cobbaert C, Proesmans W, Eggermont E (1991) Lipid and lipoprotein abnormalities in children on hemodialysis and after renal transplantation. Transplant Proc 23:1375–1377
Querfeld U, Salusky IB, Nelson P, Foley J, Fine RN (1988) Hyperlipidemia in pediatric patients undergoing peritoneal dialysis. Pediatr Nephrol 2:447–452
Wheeler DC, Morgan R, Thomas DM, Seed M, Rees A, Moore RH (1996) Factors influencing plasma lipid profiles including lipoprotein (a) concentrations in renal transplant recipients. Transpl Int 9:221–226
Silverstein DM, Palmer J, Polinsky MS, Braas C, Conley SB, Baluarte HJ (2000) Risk factors for hyperlipidemia in long-term pediatric renal transplant recipients. Pediatr Nephrol 14:105–110
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Müller, T., Koeppe, S., Arbeiter, K. et al. Serum lipid pattern unifies following renal transplantation in children. Pediatr Nephrol 18, 939–942 (2003). https://doi.org/10.1007/s00467-003-1225-y
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DOI: https://doi.org/10.1007/s00467-003-1225-y