Journal Article

Atorvastatin improves endothelial function in renal‐transplant recipients

Anders Åsberg, Anders Hartmann, Ellen Fjeldså and Hallvard Holdaas

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 16, issue 9, pages 1920-1924
Published in print September 2001 | ISSN: 0931-0509
Published online September 2001 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/16.9.1920
Atorvastatin improves endothelial function in renal‐transplant recipients

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Background. Hyperlipidaemia and endothelial dysfunction are common features in cyclosporin A (CsA)‐treated renal transplant recipients. Endothelial dysfunction may contribute to the risk of premature atherosclerosis and cardiovascular death in these patients. A beneficial effect of statin therapy beyond cholesterol lowering may be an improvement of endothelial function. The present study was designed to assess the effect of atorvastatin on serum lipids and endothelial function in CsA treated renal transplant recipients.

Methods. This pilot study was an open trial of 4 weeks atorvastatin (10 mg per day) treatment in renal transplant recipients (n=22). All patients received a CsA‐ and prednisolone‐based immunosuppressive regimen. Endothelial function was assessed in the forearm skin microvasculature by acetylcholine stimulation and laser Doppler flowmetry, before and after atorvastatin treatment. Serum lipids, plasma endothelin‐1 (ET‐1), nitric oxide (NO), and von Willebrand factor (vWF) were also measured.

Results. Both total and LDL cholesterol were significantly reduced by 26.8 ± 8.4 and 41.5 ± 11.0% respectively, after 4 weeks of treatment. Endothelial function was significantly improved during atorvastatin treatment, area under the flux versus time curve (AUC)ACh was 538 ± 362 AU×min before and 682 ± 276 AU×min after treatment (P=0.042). Plasma NO levels also showed a borderline significant increase from 49 ± 30 to 57 ± 37 μmol/l during the treatment period (P=0.051), though plasma ET‐1 (0.37±0.08 vs 0.37±0.12 fmol/ml) and vW (196±57 vs 197±37%) were unchanged.

Conclusion. Atorvastatin lowered serum cholesterol significantly and improved endothelial function in renal transplant recipients after 4 weeks of treatment. Plasma NO levels were increased during atorvastatin treatment, indicating a possible endothelial protective effect through an ‘endothelial–NO pathway’.

Keywords: atorvastatin; CsA; endothelial function; kidney; nitric oxide; transplantation

Journal Article.  3059 words.  Illustrated.

Subjects: Nephrology

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