SHORT-TERM EFFECTS OF RENAL-TRANSPLANTATION ON PLASMA-LIPIDS AND LIPOPROTEIN-LIPASE IN CHILDREN WITH CONGENITAL NEPHROSIS

Plasma lipoprotein and apoprotein (ape) A-I, A-II and B concentrations and postheparin plasma lipoprotein lipase (LPL) activity and mass wer e measured in 13 children with congenital nephrotic syndrome of the Fi nnish type (CNF) six months after renal transplantation to determine w hether the severe lipid abnormalities documented prior to and during p eritoneal dialysis would normalize. Plasma total triglyceride decrease d by 52% (p <0.001), VLDL triglyceride by 55% (p <0.01) and total chol esterol by 17% (p <0.01). HDL cholesterol increased by 51% (p <0.001), whereas no significant change was observed in LDL cholesterol. Despit e these improvements, plasma lipoprotein concentrations were still abn ormal after transplantation. Total (p <0.01) and VLDL triglyceride (p <0.05) as well as total (p <0.01), VLDL (p <0.01) and LDL cholesterol (p <0.01) were higher than in control children. HDL cholesterol normal ized. Plasma apo A-I and A-II concentrations were normal, but the apo B concentration remained high (p <0.01). Post-heparin LPL activity and mass were normal (25.0+/-9.1 mu mol FFA/ml/h and 227.2+/-88.4 ng/ml). The mean cyclosporine dose correlated positively with the serum creat inine concentration (r=+0.72, p <0.01). Positive correlations were als o observed between total (r=+0.68, p <0.05) and VLDL triglyceride (r=0.62, p <0.05) and the serum creatinine concentrations. We conclude th at renal transplantation substantially improves the triglyceride and c holesterol abnormalities in CNF but significant abnormalities still pe rsist.