FACTORS INFLUENCING PLASMA-LIPID PROFILES INCLUDING LIPOPROTEIN (A) CONCENTRATIONS IN RENAL-TRANSPLANT RECIPIENTS

Pasting plasma cholesterol, triglycerides, high-density lipoprotein (H DL) and apoprotein (ape) B were elevated in 214 nondiabetic renal tran splant recipients when compared to a reference group. Apo (a) was slig htly but not significantly lower in transplant recipients (median 118 mg/dl, range 16-1680 vs 130 mg/dl, 10-1176) and this difference could be predicted from Lp (a) isoform analysis. Cholesterol, triglyceride, apo B and apo (a) concentrations correlated negatively with creatinine clearance but none of these parameters showed a significant associati on with proteinuria. Patients treated with steroids had higher plasma HDL concentrations than those receiving cyclosporin monotherapy (P < 0 .01). The use of diuretics was associated with raised triglycerides (P < 0.001) and cholesterol (P < 0.01) and with reduced HDL (P < 0.01) w hilst patients receiving beta-blockers had significantly higher trigly cerides (P < 0.01) and lower HDL levels (P < 0.02). In multiple regres sion analysis, age (P < 0.01), creatinine clearance (P < 0.05) and diu retic therapy (P < 0.005) were independent risk factors for increased cholesterol whilst apo (a) levels correlated negatively with creatinin e clearance (P < 0.005). These results suggest that impaired renal fun ction, steroids and non-immunosuppressive drugs contribute to lipid ab normalites in renal transplant recipients.