Cyclosporin A has no impact on alterations of the lipid profile after renal transplantation

The literature contains conflicting ideas regarding the role of cyclosporin A (CyA) in the induction of posttransplant dyslipidemia. The available studies contain small numbers of patients, especially on CyA monotherapy. We compared 65 patients on conventional azathioprine-prednisone therapy (AP) with 85 patients on CyA monotherapy, 19 on CyA-azathioprine therapy (CA), 20 on CyA-prednisone therapy (CP), and 52 on a triple therapy with CyA, azathioprine, and prednisone (CAP). From the results, it is concluded that patients on CyA monotherapy had lower serum cholesterol levels, with a lower high-density lipoprotein (HDL)-cholesterol level, probably due to the lower total cholesterol, compared with AP patients. From all groups, the CyA monotherapy group showed the most beneficial lipid profile. No additive negative influences of CyA when combined with other immunosuppressive drugs were noted. Thus, a correlation between derangements of the lipid profile and CyA therapy could not be confirmed. Further analysis of our data showed negative influences of antihypertensive treatment on lipid metabolism, particularly in the case of treatment with β-blockers or diuretics. It cannot be excluded that studies showing a negative influence of CyA therapy on lipid homeostasis were biased by secondary factors like antihypertensive therapy, which was often not taken into account.