Efectos de las estatinas en el trasplante renal

A retrospective analysis was performed to assess the immunosuppressive activity of statins in kidney transplantation, determining their effects on serum cholesterol and triglyceride levels postransplantation, on the incidence of acute rejection episodes and on renal function. A total of 97 patients who underwent a kidney transplant in a three-year period, had more than one-month graft survival, and a minimum of one year of follow-up, were included. Group A consisted of 38 patients who received statins; this group was subsequently divided into four subgroups, according to the time post-transplant when statins were prescribed. Group B consisted of 59 patients (control Group). Initial and final serum total cholesterol levels in Group A were not different (218 ± 7.8 mg/dl vs 222 ± 7.5 mg/dl); however, final levels were higher than initial values in Group B (216 ± 6.0 mg/dl vs 189 ± 6.4 mg/dl, P = 0.0021). Initial serum triglyceride levels were higher than final levels in Group A (305 ± 25.5 mg/dl vs 188 ± 10.6 mg/dl, P < 0.0001). Group A showed a better allograft survival (P = 0.0350), a reduction in the incidence of acute rejection episodes (1 vs 38 events, P < 0.0001) and a lower serum creatinine level (1.96 ± 0.21 mg/dl vs 2.77 ± 0.27 mg/dl, P = 0.0374). In Group A subgroups, kidney function was significantly better in patients who received statins early after transplantation. These data suggest that in kidney transplantion statins exert additional immunosuppressive effects, reduce the number of acute rejection episodes, improve allograft survival and kidney function and are effective in preventing serum cholesterol from rising; these effects correlate with a significant decrease in serum triglyceride but are independent of a hypocholesterolemic action.