Document Detail


Unusual pattern of dyslipidemia in children receiving steroid minimization immunosuppression after renal transplantation.
MedLine Citation:
PMID:  20507961     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Corticosteroids are an important contributor to posttransplant hyperlipidemia. Since 2004, we have used a steroid minimization immunosuppression protocol. This study investigated the effect of steroid minimization on dyslipidemia in pediatric renal allograft recipients.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Children (<18 years) who underwent renal transplants at our center from January 2001 to January 2008 were studied. Data analyzed included age, gender, race, body mass index, cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, and steroid dose. Data between the cohorts receiving maintenance steroids and steroid-minimization were compared using multivariable analyses. The primary outcome measures were the prevalence of, and the effect of steroid use, on dyslipidemia.
RESULTS: Twenty-nine patients were studied. Sixteen were receiving maintenance steroids, and 13 were on a steroid minimization regimen. Mixed effects analysis of covariance models demonstrated that at 1 month, children receiving maintenance steroids had higher cholesterol compared with the steroid minimization group. Statistically significant differences in total cholesterol were not seen at other time points. Similar findings were noted for the LDL cholesterol, LDL/HDL, and cholesterol/HDL ratios. At 1 month, the serum HDL cholesterol was substantially lower in the steroid minimization group. Differences in the HDL cholesterol levels remained significant throughout the first year.
CONCLUSIONS: Steroid use is a significant independent risk factor for hypercholesterolemia during the first post-transplant month. The significance of lower HDL cholesterol among patients receiving steroid minimization needs further study and may be cause for concern.
Authors:
Keith K Lau; Daniel J Tancredi; Richard V Perez; Lavjay Butani
Publication Detail:
Type:  Journal Article     Date:  2010-05-27
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  5     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-09     Completed Date:  2010-11-30     Revised Date:  2011-08-03    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1506-12     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Biological Markers / blood
California
Child
Child, Preschool
Cholesterol / blood*
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Hypercholesterolemia / blood,  chemically induced*,  prevention & control
Immunosuppressive Agents / administration & dosage,  adverse effects*
Kidney Transplantation*
Male
Pravastatin / therapeutic use
Retrospective Studies
Steroids / administration & dosage,  adverse effects*
Time Factors
Transplantation, Homologous
Treatment Outcome
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Immunosuppressive Agents; 0/Steroids; 0/Triglycerides; 57-88-5/Cholesterol; 81093-37-0/Pravastatin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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