Activity of statins in kidney transplantation.

A retrospective analysis was performed to assess the immunosuppressive acti vity of statins in kidney transplantation, determining their effects on ser um cholesterol and triglyceride levels postransplantation, on the incidence of acute rejection episodes and on renal function. A total of 97 patients who underwent a kidney transplant in a three-year period, had more than one -month graft survival, and a minimum of one year of follow-up, were include d. Group A consisted of 38 patients who received statins; this group was su bsequently divided into four subgroups, according to the time post-transpla nt when statins were prescribed. Group B consisted of 59 patients (control Group). Initial and final serum total cholesterol levels in Group A were no t different (218 +/- 7.8 mg/dl vs 222 +/- 7.5 mg/dl); however, final levels were higher than initial values in Group B (216 +/- 6.0 mg/dl vs 189 +/- 6 .4 mg/dl, P = 0.0021). Initial serum triglyceride levels were higher than f inal levels in Group A (305 +/- 25.5 mg/dl vs 188 +/- 10.6 mg/dl, P < 0.000 1). Group A showed a better allograft survival (P = 0.0350), a reduction in the incidence of acute rejection episodes (1 vs 38 events, P < 0.0001) and a lower serum creatinine level (1.96 +/- 0.21 mg/dl vs 2.77 +/- 0.27 mg/dl , P = 0.0374). In Group A subgroups, kidney function was significantly bett er in patients who received statins early after transplantation. These data suggest that in kidney transplantion statins exert additional immunosuppre ssive effects, reduce the number of acute rejection episodes, improve allog raft survival and kidney function and are effective in preventing serum cho lesterol from rising; these effects correlate with a significant decrease i n serum triglyceride but are independent of a hypocholesterolemic action.