THERAPY OF POSTRENAL TRANSPLANTATION HYPERLIPIDEMIA - COMPARATIVE-STUDY WITH SIMVASTATIN AND FISH-OIL

Background. Recipients of renal transplantation (RT) exhibit disturban ces of serum lipids and apoproteins that may contribute to their cardi ovascular 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 uti lized in many Transplant Units. The aim of our study was to evaluate p ost-RT hyperlipidaemia control with simvastatin or fish oil. Methods. Forty-three RT patients (36 men and 17 women) with persistent hypercho lesterolaemia and stable graft function which were resistant to a lipi d-lowering diet (American Heart Association Step Two) were randomized into two groups and treated for 3 months with simvastatin (S) (10 mg/d ay; 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 Al (Apo Al), and apolipoprotein B (Apo B) were mon itored and at the study baseline they were similar between the two gro ups. Results. No side effects were detected after 3 months of therapy. In group S, the concentrations of TC (271 +/- 46 mg% vs 228 +/- 49 mg %; P < 0.001), TG (180 +/- 78 vs 134 +/- 45; P < 0.01), LDL-C (177 +/- 40 vs 144 +/- 43; P < 0.01) and Apo B (96 +/- 18 vs 82 +/- 16 P < 0.0 01) were significantly reduced, and Apo Al 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 sign ificantly reduced. Conclusions. We concluded that low-dose simvastatin and fish oil are both effective and safe in correcting post-RT hyperl ipidaemia. Further prospective studies with larger follow-up are neede d to clarify whether this therapy has an impact on cardiovascular morb idity and mortality in RT patients.