The impact and treatment of obesity and dyslipidaemias in renal transplantation

Statin therapy ameliorates renal allograft function

BACKGROUND

Statins have proven ability as antilipidemic agents and benefit cardiovascular survival in transplant recipients. The pleiotropic effects of statins on renal function in renal allograft recipients are still undetermined.

METHODS

Statin therapy was initiated according to guidelines for cardiovascular protection. Serum creatinine concentration and estimated glomerular filtration rate (eGFR) were analyzed before and after introduction of statins. The 73 patients who were retrospectively studied included those who were dialysis-dependent. Mean changes in eGFR and lipid profile were compared before and after commencing statins using chi(2) tests.

RESULTS

Mean serum creatinine concentration 18 months before starting statin therapy was 160.13 mumol/L, and 24 months after starting statin therapy was 172.22 mumol/L. Mean eGFR was 53.40 mL/min 18 months before starting statin therapy, and decreased to 49.43 mL/min after starting statin therapy. This represented a decline in renal function of 0.22 mL/min/mo over 18 months. The eGFR at 12 months after beginning statin therapy was 52.67 mL/min, and at 24 months was 49.06 mL/min. The rate of decline of eGFR after starting statin therapy was significantly lower: 0.02 mL/min/mo over 24 months (P < .001). Total cholesterol and low-density lipoprotein cholesterol concentrations were significantly decreased after starting statin therapy (P < .001). Four of 73 patients developed graft failure within 24 months.

CONCLUSION

Statin therapy in our setting was associated with a lower rate of decline in renal function in renal allograft recipients within 2 years of starting treatment.