Ezetimibe treatment in hypercholesterolemic kidney transplant patients is safe and effective and reduces the decline of renal allograft function: A pilot study

Background. Ezetimibe has shown efficacy in the therapy of hypercholesterolemia in renal transplant patients. This is the first study investigating the effect of ezetimibe on renal function in kidney transplant recipients. Methods. Fifty-six patients with statin-resistant hypercholesterolemia (total cholesterol >200 mg/dl) after renal transplantation received additional ezetimibe therapy (10 mg/day) for 12 months. A group receiving statin therapy (n = 28) served as controls in this prospective study. Results. Total cholesterol and LDL cholesterol concentrations decreased significantly in the ezetimibe-treated patients but remained stable in the control group (delta total cholesterol: -24 ± 49 mg/dl vs 19 ± 49 mg/dl, P < 0.01; delta LDL: -30 ± 39 mg/dl vs - 3 ± 31 mg/dl, P < 0.01). Mean creatinine clearance remained stable in ezetimibe-treated patients but decreased significantly in control group (delta Cockcroft-Gault: 0.9 ± 7.3 ml/min vs - 4.8 ± 12.8 ml/min, P = 0.025; delta Modification of Diet in Renal Disease: -0.4 ± 6.2 ml/min/1.73 m² vs 4.7 ± 8.8 ml/min/1.73 m², P = 0.033). Conclusions. The data of our prospective case-control study suggest that ezetimibe appears to ameliorate the decline of renal function after renal transplantation.