RELATION OF CYCLOSPORINE BLOOD LEVELS TO ADVERSE EFFECTS ON LIPOPROTEINS

Abstract

Hyperlipidemia is common in renal allograft recipients. To elucidate the role of cyclosporine in posttrans-plant hyperlipidemia, we measured lipids, lipoprotein lipids, and apolipoproteins of thirty-five renal allograft recipients and evaluated their relation to trough cyclosporine blood levels. All patients were on a triple immunosuppressive regimen with equal doses of prednisone and azathioprine, and had stable graft function. Cyclosporine blood levels were significantly correlated to total plasma cholesterol (P=0.028), low-density lipoprotein cholesterol (P=0.022), apolipoprotein B (P=0.017), and the cholesterol/high-density lipoprotein cholesterol ratio (P<0.002), but not to plasma triglycerides. Significant inverse correlations were found between cyclosporine blood levels and high-density lipoprotein cholesterol (P=0.034), high-density lipoprotein3 cholesterol (P=0.025), and apolipoprotein A-1 (P=0.047), but not high-density lipoprotein2 cholesterol. The independent relation of cyclosporine blood levels to each of the measured lipid parameters was investigated by a stepwise regression model including age, body mass index, interval from transplantation, diabetes mellitus, plasma creatinine, and intake of diuretics and β-blockers. After correction for these 7 variables, cyclosporine blood levels remained significantly associated with high-density lipoprotein cholesterol, high-density lipoprotein3 cholesterol, apolipoprotein A-1, apolipoprotein B, low-density lipoprotein cholesterol, and the cholesterol/high-density lipoprotein cholesterol ratio. These data suggest that cyclosporine causes atherogenic dyslipidemia.