International Urology and Nephrology 30 (6), pp. 767- 775 (1998) The Importance of Obesity and Hyperlipidaemia in Patients with Renal Transplants L. L6CSEY,* L. ASZTALOS,** ZS. KINCSES,** CS. BERCZI,** GY. PARAGH*** *EuroCare Hungary, Health Service, 10th Dialysis Centre, 1st Department of Medicine, Ken6zy Gyula Hospital, Debrecen; ** 1 st Department of Surgery and *** 1 st Department of Medicine, University Medical School, Debrecen, Hungary (Accepted August 30, 1998) The authors studied dyslipidaemia and "obesity" in 137 patients (87 males and 50 females) following cadaver renal transplantation with regard to the applied im- munosuppressive treatment and the patients' hypertension. The most extreme dys- lipidaemic values, the highest levels of total cholesterol, LDL and Apo were found 6 to 18 months after successful transplantation; these values were significantly high- er in women than in men. While in the dialysis programme only 21.89% of the pa- tients had BMI values higher than 25.1 kg/m2, after transplantation their proportion was 36.49%. In addition to hyperlipidaemia, hyperuricaemia was encountered in 39.42%, erythrocytosis in 8.76% and diabetes mellitus in 9.48%, respectively. In the group of patients treated only with Cyclosporine-A the incidence ofhy- perlipidaemia and hypertension was significantly lower than in those receiving a combination of either corticosteroids and Cyclosporine-A or corticosteroids, Cyclo- sporine-A and azathioprine. There was a close relationship between the unfavour- able tendency of obesity and the measured hyperlipidaemia. On the other hand, the extent of proteinuria did not always have a positive correlation with the increase of BMI and body weight, the severity of hypertension and hyperlipidaemia. The authors emphasize the importance of a systematic control of the lipid levels, the significance of a diet with an adequate carbohydrate and lipid content, and the necessity of avoiding obesity by selecting the optimal immunosuppressive treatment. Introduction In the developed Western countries cardiovascular morbidity and mortal- ity are the first among the causes of all morbidities and mortalities. Therefore in the last decades efforts have been increased to investigate the pathogenesis of atherosclerosis. Epidemiological studies of the earlier decades called atten- tion to the role of the so-called risk factors in its development [1-4, 10, 16-18]. From among them, hypertension, smoking, hyperlipidaemia and diabetes mel- litus are of special significance. The examinations of patients treated in the chronic haemodialysis pro- grammes in the 1970s and 1980s revealed that a considerable proportion of the mortalities was due to atherosclerotic complications [3-5, 9, 18]. Later on Kluwer Academic Publishers, Dordrecht Akaddmiai Kiad6, Budapest