POSTTRANSPLANT HYPERLIPIDEMIA - THE TREATMENT DILEMMA

Hyperlipidemia occurs in the majority of renal transplant recipients and may play an important role in the development of posttransplant cardiovascular disease. Although many clinical factors are associated with posttransplant hyperlipidemia, corticosteroids and cyclosporine clearly play key pathogenetic roles. Aside from cautious reduction of immunosuppression and appropriate dietary restrictions, therapeutic strategies for the management of posttransplant hyperlipidemia are limited, in part, due to special pharmacologic considerations in transplant recipients receiving cyclosporine. Based on recent studies suggesting that low doses of 3-hydroxy-3-methylglutaryl coenzyme A (HMGCoA) reductase inhibitors are safe and effective, these agents have emerged as the drugs of first choice in the pharmacologic treatment of posttransplant hypercholesterolemia. Considering the increasing importance of cardiovascular disorders as major causes of posttransplant morbidity and mortality, additional studies are warranted to delineate the relationship between posttransplant hyperlipidemia and posttransplant cardiovascular disease, and to find safe and effective strategies for reducing lipid levels after renal transplantation. © 1994, National Kidney Foundation. All rights reserved. All rights reserved.