PLASMA KINETICS OF CHYLOMICRON-LIKE EMULSION IN RENAL-TRANSPLANT PATIENTS RECEIVING CYCLOSPORINE-BASED IMMUNOSUPPRESSION

Background: Atherosclerotic cardiovascular disease is prevalent among renal transplant patients. Increase in serum total cholesterol, low-de nsity lipoprotein, and very low-density lipoprotein is common in those patients. Alterations in chylomicron metabolism, however, are also re lated to atherogenesis and were not studied in renal transplant. Hypot hesis: The aim of this study was to evaluate chylomicron metabolism in renal transplant recipients receiving cyclosporin-based immunosuppres sion. We determined the plasma kinetics of triglyceride-rich emulsions labeled with [H-3]triolein and [C-14]cholesteryl oleate that are know n to mimic the chylomicron metabolism when injected into the blood str eam. Methods: Fourteen renal transplant recipients with normal renal f unction (10 men, 4 women, aged 40 +/- 6.1 years) and 17 age-and gender -matched healthy controls received bolus injections of the chylomicron -like emulsion. Plasma samples were then taken at regular intervals du ring 60 min. Disappearance curves of the labels and the respective fra ctional clearance rates (FCR) were calculated in order to measure lipo lysis and chylomicron remnant removal from the plasma. Results: Fastin g serum lipid levels did not differ in the two groups. The difference between Median FCR of [H-3]triolein emulsion in renal transplant patie nts and that obtained in the controls (0.07 vs. 0.11 min(-1), NS) was not statistically signifi cant. Median FCR of [C-14]cholesteryl oleate also did not differ between the groups (patients: 0.044; controls: 0. 046, NS). Conclusion: These results indicate that neither chylomicron lipolysis nor remnant removal are affected in stable renal transplant patients treated with cyclosporin-based immunosuppression.