Clinical Comparison of Serum Lipids between Cyclosporine and Tacrolimus Treated Renal Transplant Recipients
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Dyslipidemia is a common complication of renal transplantation referred to as new onset dyslipidemia. Immune suppressants, in particular cyclosporine, the calcineurin inhibitor and others are known to cause dyslipidemia through non-competitive inhibition of sterol 27-dehydroxylase (CYP27A1). On the other hand, dyslipidemia has been found to be associated with higher graft rejection due to decrease in immune suppressant activity and direct graft destruction. Hence the study was designed to analyze the effect of dyslipidemia on chronic allograft rejection.
This retrospective observational study was carried out in the nephrology department of a multispecialty hospital for a period of two months. Clinical and biochemistry reports of 142 renal transplant recipients were collected in designed case report forms. All statistical analysis was carried out using IBM SPSS Statistics 17 and Graph pad Prism 6.0.
Higher serum lipid levels are observed in patients with cyclosporine therapy than tacrolimus. However statistical significant difference only in levels of total cholesterol, LDL-C, triglycerides was observed between cyclosporine and tacrolimus treated patients (P<0.001).
Dyslipidemic potential of tacrolimus is comparatively lesser than cyclosporine. However, tacrolimus causes dyslipidemia to a lesser when compared to cyclosporine. Thus monoclonal antibodies such as rituximab or basiliximab should be preferred over conventional immune suppressants. However, the cost effectiveness of monoclonal antibody therapy is high. Hence we conclude that tacrolimus with dose intense therapy should be preferred as first line immunosuppressant regimen.
Renal transplant, Immunosuppressant, Metabolic Syndrome, Dyslipidemia, Graft Rejection.