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347 SERIAL MONITORING OF LIPID PROFILES IN CHILDREN RECEIVING PRAVASTATIN AFTER RENAL TRANSPLANTATION
  1. L. Butani
  1. Sacramento, CA.

Abstract

Hyperlipidemia is common after renal transplantation (Tx), especially in children, and contributes to the increased cardiovascular morbidity seen in the post-Tx period. Limited data are available on the safety and utility of the ‘statins' in improving lipid profiles in children after renal Tx. This 12-month prospective study was undertaken to determine the effect of pravastatin on lipid profiles after renal Tx in children. From 8/01 to 4/04, all 17 newly transplanted pediatric renal Tx recipients at our center were pre-emptively treated with pravastatin from the immediate post-Tx period. Fasting lipid profiles were obtained at 1, 3, 6 and 12 months after Tx. Trends in the lipid profile with time were analyzed using the Repeated Measures General Linear Model (GLM). A matched historical cohort of Tx recipients not treated with pravastatin was used as a control population for comparison. The mean/standard deviation (SD) age of the children at Tx was 8.7 (6.7) years. There were 8 (47%) males; 11 (65%) were Latino, while the remaining were Caucasian. Most patients were receiving tacrolimus and mycophenolate mofetil and all but 2 were also on steroids. Table shows the data on the serial lipid profiles in these children. The GLM analysis showed that with time, there was a statistically significant decline in the total cholesterol, serum triglyceride, LDL and also HDL cholesterol (p value ≤0.005 for each). Compared to the controls, the mean serum cholesterol was lower at all time points post-Tx in the treated patients. However, in spite of treatment, the prevalence of hypercholesterolemia increased from 31% pre-Tx to 53% at 1-month, but declined thereafter to 6% (3 and 6 months) and to 0% at 1year. No child developed any complications related to therapy and none needed drug discontinuation. In summary, pravastatin is safe in the post-Tx period in children and reduces serum cholesterol and LDL cholesterol. A novel observation in our study was the decline in HDL cholesterol with pravastatin. Whether the pre-emptive use of the statins will result in lower cardiovascular morbidity, especially considering the concomitant reduction in HDL cholesterol seen in our study remains to be determined.

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