Nephrology Dialysis Transplantation, Vol 12, Issue 10 2140-2143, Copyright © 1997 by Oxford University Press
R Castro, J Queiros, I Fonseca, J Pimentel, A Henriques, A Sarmento, S Guimaraes and M Pereira
Background: Recipients of renal transplantation (RT)
exhibit disturbances of serum lipids and apoproteins that may contribute to
their cardiovascular morbidity and mortality. In our renal transplant
department the hypercholesterolaemia prevalence at the first and fifth year
of RT is 70.0% and 81.2%, respectively. Lipid-lowering therapy has been
utilized in many Transplant Units. The aim of our study was to evaluate
post-RT hyperlipidaemia control with simvastatin or fish oil.
Method: Forty-three RT patients (26 men and 17 women)
with persistent hypercholesterolaemia and stable graft function which were
resistant to a lipid-lowering diet (American Heart Association Step Two)
were randomized into two groups and treated for 3 months with simvastatin
(S) (10 mg/day; n=25) and fish oil (F) (6 g/day; n=18). Total cholesterol
(TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), lipoprotein a
(Lp(a)), apolipoprotein A1 (Apo A1), and apolipoprotein B (Apo B) were
monitored and at the study baseline they were similar between the two
groups. Results: No side effects were detected after 3
months of therapy. In group S, the concentrations of TC (271±46
mg% vs 228±49mg%; P <0.001), TG (180±78 vs
134±45; P<0.01), LDL-C (177& plusmn;40 vs
144±43; P <0.01) and Apo B (96±18 vs
82±16; P <0.001) were significantly reduced, and Apo A1
concentration had increased (135±24 vs 149±30; P
<0.01). In group F, the concentrations of TC (266±25 vs
240±31; P <0.001), TG (203±105 vs
156±72; P=0.02) and HDL-C (63±15 vs 53±12;
P <0.01) were significantly reduced.
Conclusion: We concluded that low-dose simvastatin and
fish oil are both effective and safe in correcting post-RT hyperlipidaemia.
Further prospective studies with larger follow-up are needed to clarify
whether this therapy has an impact on cardiovascular morbidity and
mortality in RT patients. Keywords: fish oil;
hyperlipidaemia; renal transplantation; simvastatin
ORIGINAL ARTICLES
Therapy of post-renal transplantation hyperlipidaemia: comparative study with simvastatin and fish oil
Transplant Department, Servico de Nefrologia, Hospital Geral de Santo Antonio, Largo da Escola Medica, 4050 Porto, Portugal; Corresponding author
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