The Effect of Hypercholesterolemia and Hypertension on Long-term Renal Allograft Survival

Lee, Min Ro; Kim, Min Young; Ha, Jongwon; Kim, Sang Joon

Abstract

PURPOSE: In kidney transplant recipients, chronic transplant nephropathy is the major cause of graft failure after the first posttransplant year. Because histological features of chronic transplant nephropathy closely resemble those of early atherosclerosis, the importance of hypercholesterolemia and hypertension, which are the risk factors of atherosclerosis, have recently been emphasized. In this study, we investigated the effects of hypercholesterolemia and hypertension on long-term renal allograft survival.
METHODS
A retrospective analysis was performed on 218 renal transplants from the 261 renal transplants between 1992 and 1997, excluding 14 with early graft loss (<1 years) and 29 whose data were unavailable. The serum cholesterol level and systolic and diastolic blood pressures were recorded at the time of transplantation, and 1 and 2 year after.
RESULTS
The recipients with hypercholesterolemia (>or= 240 mg/dl) at the time of transplantation (n=12) showed lower 5 year graft survival rate (83% vs. 99%; P<0.01) compared with that of the normal cholesterol level recipients (n=97). A multivariate analysis confirmed that hypercholesterolemia at the time of transplantation was an independent risk factor for long-term graft loss (P=0.04). But hypertension did not show a statistically significant relationship with long-term graft survival.
CONCLUSION
Hypercholesterolemia at the time of transplantation is an independent risk factor for long-term graft loss. Correction of hypercholesterolemia from the pretransplantation period may improve long-term graft survival.