RENAL TRANSPLANT RECIPIENTS

Abstract

Introduction: Good glycemic control and lipid modification are potentiallyimportant intervention for improving outcome after kidney transplantation. Objective: Todetermine the frequency of dyslipidemia and its types in renal transplant recipients (RTRs),and to observe impact of hyperglycemia on their lipid profile. Design: Case control study.Period: June 2011 to May 2012. Setting: Kidney Dialysis Department of Jinnah HospitalLahore, Urology Department of Mayo Hospital Lahore and Pathology Department AllamaIqbal Medical College Lahore. Patients and Methods: A total of 40 RTR were included in thestudy. An equal number of sex and age matched healthy subjects were considered as controlgroup. The patients were on regular post transplant follow up in Kidney Dialysis Department ofJinnah Hospital Lahore and Urology Department of Mayo Hospital Lahore and had no clinicalor laboratory evidence of graft rejection, post-transplant diabetes mellitus, hypertension or intercurrent infection. Total cholesterol (TC), triglyceride (TG), High density Lipoprotein-Cholesterol(HDL-C), and Glycohemoglobin A1c (HbA1c) were estimated in all subjects. These subjectswere divided into Diabetic and non-diabetic groups, according to level of HbA1c. Results:The mean age of the RTR was 34.5± 9.02 years and the mean duration of transplant was36.70 ± 38.07 months. RTRs showed significantly high mean levels of TG (p< 0.002), TC (p<0.00), LDL-C (p< 0.01), and HDL-C (p< 0.05) as compared to the control subjects. ElevatedTC, TG, LDL-C and low HDL was observed in 32.5%, 72.5%, 52.5%, and 60% of total RTR,respectively. The mean levels of TC, TG and HDL-C were increased in Diabetic transplant groupas compared to non-diabetic RTR. Percentage of elevated TC, TG, LDL-C and decreased HDLin diabetic group of RTR versus non diabetic RTR was 43.7% Vs 25% , 81.2% Vs 66.6%, , 62.5%Vs 44.4%, and 50% Vs 66.6% respectively. There was a positive relationship between HbA1cand lipid profile (TC, TG, and LDL – C) in both Diabetic and Non Diabetic Group. A statisticallysignificant correlation of the mean HbA1c levels with TG level was observed in Diabetic RTR.Conclusion: Dyslipidemia in our RTRs was observed as elevated levels of TC, TG and LDL-C. Indiabetic RTR, a statistically significant positive correlation of the HbA1c levels with TG level wasobserved. More rigorous glycemic control and lipid modification will reduce the development ofmicrovascular complications.