Dyslipidemia in Kidney Transplant Recipients: Implications for Graft Prognosis and Lipid Management
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Keywords

Kidney transplantation
Dyslipidemia
Graft outcomes
Lipid management

DOI

10.26689/jcnr.v10i4.14863

Submitted : 2026-04-20
Accepted : 2026-05-05
Published : 2026-05-20

Abstract

Dyslipidemia is a common metabolic complication after kidney transplantation, affecting 75-95% of recipients. Increasing evidence links post-transplant lipid abnormalities to graft dysfunction and eventual graft loss. However, studies on conventional lipid markers have reported inconsistent associations with transplant outcomes. Emerging lipid indicators may better reflect the burden of atherogenic lipoproteins and provide additional value for risk stratification after transplantation. This review summarizes current evidence on the epidemiology, mechanisms, graft outcome associations, and management of dyslipidemia in kidney transplant recipients, with a focus on postoperative monitoring and prognostic assessment.

References

Wallace Z, Wallwork R, Zhang Y, et al., 2018, Improved Survival with Renal Transplantation for End-Stage Renal Disease Due to Granulomatosis with Polyangiitis: Data from the United States Renal Data System. Annals of the Rheumatic Diseases, 77(9): 1333–1338.

Poggio E, Augustine J, Arrigain S, et al., 2021, Long-Term Kidney Transplant Graft Survival—Making Progress When Most Needed. American Journal of Transplantation, 21(8): 2824–2832.

Arabi Z, Tawhari M, Arabi T, et al., 2025, Kidney Transplantation and Statins Effects on Dyslipidemia in Kidney Transplant Recipients. Annals of Medicine & Surgery, 87(11): 7004–7010.

Cohen E, Korah M, Callender G, et al., 2020, Metabolic Disorders with Kidney Transplant. Clinical Journal of the American Society of Nephrology, 15(5): 732–742.

Gelpi R, Casas A, Taco O, et al., 2025, Kidney Transplant: More Than Immunological Problems. Journal of Clinical Medicine, 14(6): 2101.

Szili-Torok T, De Borst M, Soteriou A, et al., 2024, Apolipoprotein B-48 and Late Graft Failure in Kidney Transplant Recipients. Clinical Kidney Journal, 17(10): sfae289.

Schaeffner E, Fodinger M, Kramar R, et al., 2006, Prognostic Associations Between Lipid Markers and Outcomes in Kidney Transplant Recipients. American Journal of Kidney Diseases, 47(3): 509–517.

Badiou S, Cristol J, Mourad G, 2009, Dyslipidemia Following Kidney Transplantation: Diagnosis and Treatment. Current Diabetes Reports, 9(4): 305–311.

Paccagnella C, Andreola S, Gambaro A, et al., 2025, Immunosuppressive Therapy-Related Cardiovascular Risk Factors in Renal Transplantation: A Narrative Review. Cardiorenal Medicine, 15(1): 209–228.

Bagley J, Williams L, Hyde M, et al., 2019, Hyperlipidemia and Allograft Rejection. Current Transplantation Reports, 6(1): 90–98.

El Aggan H, Mahmoud S, El Shair H, et al., 2021, Increased Macrophage Activation Marker Soluble CD163 Is Associated with Graft Dysfunction and Metabolic Derangements in Renal Transplant Recipients. Biomedical Journal, 44(6): S179–S189.

Vieira T, Limirio L, De Oliveira E, 2024, Association of Uric Acid with Body Adiposity and Biochemical Parameters in Kidney Transplant Patients. Clinical Nutrition ESPEN, 64: 84–91.

Akioka K, Takahara S, Ichikawa S, et al., 2005, Factors Predicting Long-Term Graft Survival After Kidney Transplantation: Multicenter Study in Japan. World Journal of Surgery, 29(2): 249–256.

Zhang Y, Liu B, Meng Q, et al., 2023, Targeted Changes in Blood Lipids Improves Fibrosis in Renal Allografts. Lipids in Health and Disease, 22(1): 215.

Zhang H, Zhang H, Li R, et al., 2025, Risk Prediction of Postoperative Renal Dysfunction Based on Preoperative Lipid Profiles in Renal Transplant Recipients: A Retrospective Cohort Study. Risk Management and Healthcare Policy, 18: 2539–2550.

Taber D, Douglass K, Srinivas T, et al., 2014, Significant Racial Differences in the Key Factors Associated with Early Graft Loss in Kidney Transplant Recipients. American Journal of Nephrology, 40(1): 19–28.

Bellos I, Lagiou P, Benetou V, et al., 2024, Efficacy and Safety of Statin Therapy in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis. Lipids in Health and Disease, 23(1): 293.

Yan J, Yang X, Wang J, et al., 2023, Metabolic Risk Profile and Graft Function Deterioration 2 Years After Kidney Transplant. JAMA Network Open, 6(12): e2349538.

Secondulfo C, Izzo C, Vecchione N, et al., 2025, Apolipoproteins in Chronic Kidney Disease and Kidney Transplant: A Long Unfinished Story. International Journal of Molecular Sciences, 26(19): 9664.

Horace R, Roberts M, Shireman T, et al., 2022, Remnant Cholesterol Is Prospectively Associated with Cardiovascular Disease Events and All-Cause Mortality in Kidney Transplant Recipients: The FAVORIT Study. Nephrology Dialysis Transplantation, 37(2): 382–389.

Li B, Wang A, Wang Y, et al., 2020, A Study on the Correlation Between Remnant Cholesterol and Urinary Albumin to Creatinine Ratio in Chinese Community Adults: A Report from the REACTION Study. Journal of Diabetes, 12(12): 870–880.

Stojanovic D, Cvetkovic T, Stojanovic M, et al., 2017, Renalase Assessment with Regard to Kidney Function, Lipid Disturbances, and Endothelial Dysfunction Parameters in Stable Renal Transplant Recipients. Progress in Transplantation, 27(2): 125–130.

Lee H, Lee Y, Kim J, et al., 2025, Triglyceride-Glucose Index and Risk of Renal Function Decline and Death-Censored Renal Allograft Loss in Kidney Transplant Recipients. Kidney Research and Clinical Practice, 44(6): 974–983.

Arabi Z, Tawhari M, Alghamdi A, et al., 2024, Lipid Management in Kidney Transplant Recipients per KDIGO and American Heart Association Guidelines: A Single-Center Experience. Saudi Journal of Medicine & Medical Sciences, 12(1): 47–53.

Zhang D, Yu L, Xia B, et al., 2023, Systematic Review and Meta-Analysis of the Efficacy of Exercise Intervention in Kidney Transplant Recipients. World Journal of Urology, 41(12): 3449–3469.

Lin I, Van Duong T, Nien S, et al., 2023, High Diet Quality Indices Associated with Lower Risk of Lipid Profile Abnormalities in Taiwanese Kidney Transplant Recipients. Scientific Reports, 13(1): 19662.

Luo B, Guo L, Di W, 2025, PCSK9 Inhibitors: A Promising Lipid-Lowering Strategy for Kidney Transplant Recipients. Renal Failure, 47(1): 2604881.