Abstract
Restoration of renal function after kidney transplantation (KT) is expected to improve oxidative stress (OS). However, little is known about the influence of calcineurin inhibitors on oxidized low-density lipoproteins (ox-LDL) after KT. The aim of this study was to evaluate ox-LDLs and related markers of OS, advanced oxidation protein products (AOPP) and total antioxidant status (TAS) in patients after KT on either cyclosporin A (CyA) or tacrolimus (Tac) treatment. This was a prospective, randomized, single-center 12 month study evaluating time-dependent changes in biomarkers of OS before and after KT. Twenty nine patients (mean age 54.4 ± 11.1; 55% male and 45% female) were treated with CyA (Group A) and twenty four patients (mean age 52.9 ± 9.9; 75% male and 25% female) were treated with Tac (Group B). The ox-LDL, AOPP, TAS, lipid metabolism parameters, creatinine and glomerular filtration were assessed on day 1 before KT and on days 1 and 7, and in months 1, 3, 6 and 12 after KT. Over the 12 months, the ox-LDL for group A changed from 69.2±32.9 to 65.1±17.1 U/L (P=0.665), while AOPP significantly decreased from 233.0±159.6 to 156.5±90.1 μmol/L (P=0.025) and TAS from 1.87±0.31 to 1.68±0.20 mmol/L (P=0.030). For group B the ox-LDL changed from 62.9±29.7 to ± 61.4±14.6 U/L (P=0.168) and TAS from 1.87±0.51 to 1.68±0.20 mmol/L (P=0.168), while AOPP significantly decreased from 180.5±90.0 to 123.9±37.7 μmol/L (P=0.019). AOPP is more sensitive than ox-LDL for assessing OS after KT. TAS values appear to be insufficiently sensitive for monitoring OS in patients after KT.
Highlights
Enhanced atherosclerosis and subsequent cardiovascular complications are the leading cause of death in patients with chronic kidney disease (CKD)
To the best of our knowledge, we present the first randomized and prospectively designated study evaluating the influence of the calcineurin inhibitors cyclosporin A (CyA) and Tac on plasma levels of ox-low-density lipoproteins (LDL) in transplanted patients over a 12-month period after kidney transplantation (KT)
We found no statistically significant changes in oxLDL during the 12-month period after KT in comparison to levels before transplantation
Summary
Enhanced atherosclerosis and subsequent cardiovascular complications are the leading cause of death in patients with chronic kidney disease (CKD). Besides common risk factors for coronary heart disease such as arterial hypertension, diabetes mellitus, increasing patient age, elevated serum cholesterol, obesity and cigarette smoking, a number of other factors have been found to correlate with cardiovascular complications after kidney transplantation (KT) (ref.[3]). Substantial attention has been paid to the possible role of oxidative stress (OS) as a nontraditional risk factor for high cardiovascular morbidity and mortality among renal transplant recipients[5,6]. The predominance of ROS formation over the cellular antioxidant defence results in the oxidative damage of biomolecules, which leads to tissue damage and organ dysfunction[9]. One of the currently recommended markers characterizing OS is the level of oxidized LDL (ox-LDL) (ref.[4])
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