SAFETY AND EFFICACY OF ATORVASTATIN IN RENAL TRANSPLANT RECIPIENTS

Abstract

581 Hypercholesterolemia is a common side effect following renal transplantation. Cyclosporine and tacrolimus have both been shown to increase serum cholesterol in patients after kidney transplant. Hypercholesterolemia is a known risk factor for the development of atherosclerosis. Atorvastatin, a potent new HMG-CoA reductase inhibitor, is effective for controlling hypercholesterolemia. HMG-CoA reductase inhibitors as a class are useful for controlling hyperlipidemia. These agents, combined with cyclosporine or tacrolimus, however can cause severe muscular and hepatic toxicity which limits their use. Due to the potency of atorvastatin, we postulated that low doses would be effective in normalizing serum cholesterol levels with little toxicity in renal transplant recipients maintained on cyclosporine or tacrolimus. All patients presenting to our renal transplant clinic with serum cholesterol above 225 mg/dl were started on atorvastatin. In addition to cholesterol, we measured serum CPK, AST, and ALT prior to starting atorvastatin and after three months of therapy. All values expressed as mean± SE. The mean dose of atorvastatin was 9.4±0.3 mg. All patients were followed for a minimum of 3 months.TableAtorvastatin was very effective, lowering the serum cholesterol by greater than 20 percent. All patients remain on the drug. No patients reported muscle soreness or weakness. No patients had significant elevations in liver function tests. While there was a trend towards higher CPK levels after beginning atorvastatin, only one patient had a CPK level above the normal range for our laboratory. Atorvastatin is safe and very effective for controlling hypercholesterolemia in renal transplant patients maintained on cyclosporine or tacrolimus.