Epidemiology of dyslipidemiia in patients after kidney transplantation (EDYS-AKT 2025): results of a multicenter retrospective cohort study

<jats:p> <jats:bold>Introduction.</jats:bold> Dyslipidemia is a key risk factor (RF) for cardiovascular diseases (CVDs), with different diagnostic criteria in Europe and the United States. It can occur in 45-90% of kidney transplant patients. Analysis of the incidence of dyslipidemia and the role of lipid-lowering medications in its correction is crucial. <jats:bold>Objective.</jats:bold> To determine the incidence of dyslipidemia in patients after kidney transplantation, the prevalence of CVD RFs, as well as the frequency of prescription of lipid-lowering therapy (LLT) and its effectiveness. <jats:bold>Material and methods.</jats:bold> A multicenter retrospective cohort study (809 patients) was conducted. We identified patient groups with and without dyslipidemia, the prevalence of CVD RFs, and the immunosuppressive therapy regimens used, as well as the kidney transplant function assessed based on estimated glomerular filtration rate (eGFR). We also identified subgroups of patients receiving and not receiving lipid-lowering therapy, determined previously prescribed lipid-lowering therapy regimens, and assessed their efficacy. <jats:bold>Results.</jats:bold> The prevalence of dyslipidemia in kidney transplant patients has been reported in literature as high as 97.4%. Patients with dyslipidemia received two immunosuppressive drugs with proatherogenic properties in 66.4% of cases. In 78.7% of patients, eGFR of the kidney transplant ranged from 30 to 89.9 ml/min/1.73 m2. Ninety percent of patients had arterial hypertension, 42.1% had overweight or obesity class I–III, 15.2% had type I or II diabetes mellitus, 11.4% were smokers, and 43.3% had atherosclerosis in different vascular locations, 81.3% of patients had 1 to 3 CVD RFs simultaneously, 67.3% of patients with dyslipidemia did not receive LLT, and 32.7% were on LLT. Elevated low-density lipoprotein cholesterol (LDL-C) levels were detected in 56.3% of patients with dyslipidemia, elevated LDL-C levels and hypertriglyceridemia were found in 39.1% of cases; and hypertriglyceridemia was found in 1.9%. Among the patients in whom lipid-lowering therapy was administered, 81% received statin monotherapy, 16.7% – a combination therapy (statins and ezetimibe), and 2.3% – ezetimibe monotherapy. Combination therapy and monotherapy were effective in 8.2% of patients. <jats:bold>Conclusion.</jats:bold> The high prevalence of dyslipidemia in kidney transplant recipients suggests that lipid metabolism disorders remain underdiagnosed and inadequately controlled. Renal transplant recipients require a complex, comprehensive, systematic approach to the prevention of CVD risk factors and correction of dyslipidemia while using combination immunosuppressive therapy. </jats:p>