P8.116: Evaluation of Traditional and Non-traditional Lipid Components in Renal Transplant Recipients

Abstract

Introduction: Kidney transplantation is followed by development of additional cardiovascular risk factors. The conventional lipid markers like triglyceride, cholesterol, LDL and HDLs are generally measured as traditional lipids to identify subjects at risk of cardiovascular events. But there are other potent atherogenic risk elements like Apolipoprotein A-1, B and lipoprotein (a). When included, these may provide better assessment of dyslipidemias in renal transplant recipients. In this study we evaluated the dyslipidemia status in a group of living related kidney recipients by seeing the pattern and interaction of both groups of traditional and nontraditional lipids. Materials & Method: In this cross sectional study renal allograft recipients, at least 3-month post- transplant, were included. Laboratory investigations done were triglyceride (TG), cholesterol (TC), low density lipoprotein (LDL) and high-density lipoprotein (HDL) as traditional lipid marker and Apoliprotein B (APO B) and A1(APO A-1); and lipoprotein(a) (lipo(a)) as non-traditional lipid markers. Tests for glycemia (HbA1c), renal function (ACR, serum creatinine, eGFR), anemia (hemoglobin) and inflammation (hsCRP) were also done. Results: In this study 105 patients were included. They were mostly on triple drug therapy with tacrolimus, mycophenolate mofetyl and prednisolon. The duration of transplantation was 34±26 (4.5-112) months. Mean age was 34 ± 8 years with a male to female ratio was 7:1. The mean serum creatinine was 2.0±1.3 mg% and eGFR 52± 23 ml/mim/1.73m2. Among renal transplant recipients, 62% had elevated TG (> 150mg %), 33% had elevated TC (> 200mg %), 53% had elevated LDL (> 100mg %) and 61% had low HDL (<40mg %). The ApoA-1 was below normal (<120mg % in male and < 140 mg% in female) in 43%, Apo B elevated (> 130mg %) in 10% and Lipoprotein (a) elevated (> 30mg %) in 16%. According to abnormality in any of the traditional lipid markers 88% of the renal transplant recipients was identified with dyslipidemia. According to abnormal cut-offs dyslipidemia was identified by non-traditional lipid markers in 57%. In 12% subjects all traditional lipid markers was normal but abnormal when nontraditional ones were checked. In all subjects with traditional dyslipidemis 41% had normal nontraditional lipids. In 52% subjects both traditional and nontraditional lipid markers were in dyslipidemic range. Conclusion: Both traditional and nontraditional lipid parameters are needed to be measured in renal transplant recipients to identify the pattern and extent of dyslipidemia prevails among them. This will help in better lipid management and prescribing anti-lipid therapy to combat cardiovascular events. Partially from supports of MOE, Bangladesh and for technical support of ABC, Bangladesh.