High density lipoprotein and kidney dysfunction among post kidney transplant patients

Introduction: Dyslipidemia is commonly found in patients after kidney transplantation and it is associated with cardiovascular complications. Kidney transplant patients suffer high mortality due to cardiovascular diseases. Objective: Patients who have undergone kidney transplant, and present with chronic kidney disease (CKD) often have poor high-density lipoprotein (HDL) control. Hence, this study aims to establish a correlation between serum HDL levels in transplant recipients with kidney function. Design: A retrospective cross-sectional study, which examined 240 patients who underwent kidney transplant, and were followed up between 2006 and 2012. HDL values along estimated glomerular filtration rate (eGFR) were recorded, on a yearly basis, using EpiData entry software and then transferred to SPSS software for analysis. Results: A total of 106 patients are included out of our initial sample of 240, the rest 134 were excluded, for various causes. the age ranged from 14 to 76 years, with a mean of 42.7 years, and a median of 42 years. 62 of the included participants were males, 44 were female. Year of transplant varied from 1981 to 2013. 32 of the patients underwent live related renal transplant and 78 underwent commercial transplant. From the analysis we interpreted, with a continuity correction of p=1.000, that there was no statistically significant association between the two categorical variables (p>0.05). Conclusion: We found no statistically significant association between worsening HDL levels and renal function decline in our study population of patients who underwent renal transplant. *Correspondence to: Issa Al Salmi, The Renal Medicine Department, The Royal Hospital, Oman, Tel: 96892709000; Fax: 96824599966; E-mail: isa@ausdoctors.net Received: September 16, 2018; Accepted: September 26, 2018; Published: September 28, 2018 Introduction There is a progressive rise in the number of kidney transplant patients world-wide and in Oman [1,2]. A significant number of them whether transplanted from a living relative or commercial unrelated kidney transplant, eventually develop kidney dysfunction and failure of the graft kidney for various reasons. Patients with kidney transplantation are at increased risk of accelerated atherosclerosis and a marked increase in cardiovascular (CV) mortality [3]. Several factors are involved in the pathogenesis of atherosclerosis and CV disease in chronic kidney disease (CKD). Post-renal transplant (Tx) patients exhibit a high CV morbidity and mortality due to accumulation of CV risk factors such as oxidative stress, inflammation, hypertension, endothelial dysfunction, vascular calcification, medications, metabolic abnormalities and dyslipidemia [4]. Some of the transplant kidney dysfunctions and failures have causes that are easily identified, including infections, drugs, recurrence of original kidney disease [5]. Other transplant failures are multifactorial, and a specific cause cannot usually be identified [6]. It is not surprising that in the general population, increasing HDL cholesterol concentrations are associated with decreased atherosclerosis burden and reduced CV mortality [7]. There are few studies in the literature pertaining to correlating HDL with renal dysfunction in post renal transplant patients [8-10], however none have shown a clear association or disproved one with strong evidence, hence this topic remains controversial, also no such study has been done in our citizens in the Sultanate. Therefore, this study examines the correlation of lipids most specifically HDL (High density lipoprotein) levels in kidney transplant patients in whom a specific cause of kidney dysfunction was not very well identified, and those who suffered a gradual decline in renal function due to unknown causes.