Lipid profile in renal transplant recipients receiving immunosuppressive therapy


  • Samir Lamichhane Department of Clinical Pharmacology, Maharajgunj Medical Campus, Institute Of Medicine, Tribhuvan University, Nepal
  • Sangha Ratna Bajracharya Department of Clinical Pharmacology, Maharajgunj Medical Campus, Institute Of Medicine, Tribhuvan University, Nepal
  • Dibya Singh Shah Department of Nephrology, Maharajgunj Medical Campus, Institute Of Medicine, Tribhuvan University, Nepal



Immunosuppressive therapy, Lipid profile, Renal transplant recipients


Background: Immunosuppression has been detrimental for graft survival in renal transplant recipients (RTRs). Now that acute rejection is less of a concern, the main problem with kidney transplantation is the long term adverse effects of immunosuppression; dyslipidemia and subsequent atherosclerosis leading to cardiovascular diseases being one of them. The objective of the study was to determine the association of lipid profile with immunosuppressive therapy in RTRs.

Methods: A descriptive qualitative study was conducted in 120 live RTRs following up at the post-renal transplant clinic in 1 year duration. Means of baseline lipid profiles were compared to those of all follow ups and means of all lipid profiles done at different intervals were compared among different sub-groups of patients grouped according to different variables including the individual immunosuppressants and the immunosuppressive therapy.

Results: There was a significant increase in TC levels at 6 and 12 months. HDL-C levels were significantly higher at all follow ups and TG levels done at all follow ups were significantly higher as compared to baseline.

LDL-C(12) was significantly higher in the group with higher tacrolimus dose. LDL-C(6), LDL-C(24), TC(24) were significantly different among different prednisolone groups reflecting a relation of prednisolone with alteration in lipid profiles. None of the two regimens was found to be superior over the other regarding lipid profile.

Conclusions: This study has shown a significant alteration of lipid profile in patients after renal transplantation as compared to pre-transplant status and immunosuppressive therapy seems to be one among the various contributors to it.


Treatment Methods for Kidney Failure: Transplantation. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). NIH Publication. 2006 May. NIH Publication No. 06-4687.

Murray JE, Merrill JP, Harrison JH, Wilson RE, Dammin GJ. Prolonged Survival of Human-Kidney Homografts by Immunosuppressive Drug Therapy. N Engl J Med. 1963;268:1315-23.

Miller LW. Cardiovascular Toxicities of Immunosuppressive Agents. Am J Transplant. 2002;2(9):807-18.

Kasiske BL, Guijarro C, Massy ZA, Weiderkehr MR, Ma JZ. Cardiovascular disease after renal transplantation. J Am Soc Nephrol. 1996;7:158-65.

Kasiske BL, Chakkera HA, Roel J. Explained and unexplained ischemic heart disease risk after renal transplantation. J Am Soc Nephrol. 2000;11:1735-43.

Massy ZA. Hyperlipidemia and cardiovascular disease after organ transplantation. Transplantation. 2001;72:S13-5.

Kasiske BL. Epidemiology of cardiovascular disease after renal transplantation. Transplantation. 2001;72:S5-8.

Marcén R. Immunosuppressive drugs in kidney transplantation: impact on patient survival, and incidence of cardiovascular disease, malignancy and infection. Drugs. 2009;69(16):2227-43.

Weiner DE, Carpenter MA, Levey AS, Ivanova A, Cole EH, Hunsicker L, et al. Kidney Function and Risk of Cardiovascular Disease and Mortality in Kidney Transplant Recipients: The FAVORIT Trial. Am J Transplant. 2012;12:2437-45.

Israni AK, Snyder JJ, Skeans MA, Kasiske BL. Clinical diagnosis of metabolic syndrome: predicting new-onset diabetes, coronary heart disease, and allograft failure late after kidney transplant. Transpl Int. 2012;25:748-57.

Gunjotikar RV, Taskar SP, Almeida AF, Acharya VN. Dyslipoproteinemia in renal transplantation. J Postgrad Med. 1994;40:10.

Quaschning T, Mainka T, Nauck M, Rump LC, Wanner C, Krämer-Guth A. Immunosuppression enhances atherogenicity of lipid profile after transplantation. Kidney Int Suppl. 1999;71:S235-7.

Pannu HS, Singh D, Sandhu JS. Lipid profile before and after renal transplantation - a longitudinal study. Ren Fail. 2003;25(3):411-7.

Centers for Disease Control and Prevention. Interpretation of BMI for adults; 2014.

Durand ZW. Age of Onset of Obesity, Diabetes and Hypertension in Yap State, Federated States of Micronesia. Developing Human Resources in the Pacific. 2007;14(1):160-4.

Hartmann EL. Renal Transplantation in the Older Adult, in Geriatric Nephrology Curriculum. Geriatric Nephrology Curriculum, American Society of Nephrology; 2009:1-4.

Vaidya A, Pathak RP, Pandey MR. Prevalence of hypertension in Nepalese community triples in 25 years: a repeat cross-sectional study in rural Kathmandu. Indian Heart J. 2012;64(2):128-31.

Sharma SK, Ghimire A, Radhakrishnan J. Prevalence of Hypertension, Obesity, Diabetes, and Metabolic Syndrome in Nepal. Int J Hypertens. 2011:821971.

Kasiske BL, Umen AJ. Persistent hyperlipidemia in renal transplant patients. Medicine (Baltimore). 1987;66(4):309-16.

Tse KC, Lam MF, Yip PS, Li FK, Lai KN, Chan TM. A long-term study on hyperlipidemia in stable renal transplant recipients. Clin Transplant. 2004;18(3):274-80.

Kimak E, Solski J, Baranowicz-Gaszczyk I, Ksiazek A. A long-term study of dyslipidemia and dyslipoproteinemia in stable post-renal transplant patients. Ren Fail. 2006;28(6):483-6.

Salahi H, Jalaeian H, Nikeghbalian S, Davari HR, Bahador A, Roozbeh J, et al. The Comparison of Clinical and Biochemical Parameters among 1200 alive and dead Renal Transplant Recipients. Saudi J Kidney Dis Transpl. 2007;18:439-42.

Ames RP, Hill P. Elevation of serum lipid levels during diuretic therapy of hypertension. Am J Med. 1976;61(5):748-57.

Li HY, Li B, Wei YG, Yan LN, Wen TF, Zhao JC, et al. Higher Tacrolimus Blood Concentration Is Related to Hyperlipidemia in Living Donor Liver Transplantation Recipients. Dig Dis Sci. 2012;57(1):204-9.

Gallon L, Perico N, Dimitrov BD, Winoto J, Remuzzi G, Leventhal J, et al. Long-Term Renal Allograft Function on a Tacrolimus-Based, Pred-Free Maintenance Immunosuppression Comparing Sirolimus vs. MMF. Am J Transplant. 2006;6(7):1617-23.

Hricik DE, Mayes JT, Schulak JA. Independent effects of cyclosporine and prednisone on posttransplant hypercholesterolemia. Am J Kidney Dis. 1991;18(3):353-8.

Chan MK, Vargese Z, Persaud JW, Fernando ON, Moorhead JF. The role of multiple pharmaco-therapies in the pathogenesis of hyperlipidemia after renal transplantation. Clin Nephrol. 1981;15(6):309-13.

Bittar AE, Ratcliffe PJ, Richardson AJ. The prevalence of hyperlipidemia in renal transplant recipients: associations with immuno-suppressive and antihypertensive therapy. Transplantation. 1990;50(6):987-92.




How to Cite

Lamichhane, S., Bajracharya, S. R., & Shah, D. S. (2017). Lipid profile in renal transplant recipients receiving immunosuppressive therapy. International Journal of Basic & Clinical Pharmacology, 6(2), 393–398.



Original Research Articles