Evaluation of metabolic syndrome and associations with inflammation and graft function in renal transplant recipients

Alencastro, Mariana Gascue; Lemos, Joana; Bastos, Nícia Maria Romano de Medeiros; Vicari, Alessandra Rosa; Gonçalves, Luiz Felipe Santos; Manfro, Roberto Ceratti

doi:10.5935/0101-2800.20130049

Cited by 7 publications

(5 citation statements)

References 42 publications

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“…En esta serie el incremento promedio fue 6,6 kg. Se ha observado que el mayor incremento de peso ocurre en los primeros 6 meses del TxR asocia con frecuencia al desarrollo de hipertensión arterial, resistencia a la insulina, síndrome metabólico, diabetes mellitus, hiperlipidemia y enfermedad coronaria 6,13,17,29,33,34 . Todas estas condiciones se han asociado a una mayor mortalidad en la población general.…”

Section: Discussionunclassified

“…Se ha sugerido que la obesidad representa un estado inflamatorio de baja intensidad con un rol potencial en la patogénesis y agravación de la hipertensión arterial y la disfunción endotelial 37 . Es frecuente que los pacientes que incrementan su IMC después del TxR tengan una PCR más elevada que los pacientes con IMC normal y que desarrollen hiperinsulinemia y síndrome metabólico 34 . La inflamación de bajo grado puede modular el impacto del síndrome metabólico sobre el injerto 27 .…”

Section: Discussionunclassified

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Influencia de la ganancia de peso durante el primer año del trasplante renal en la sobrevida de injertos y pacientes

Vega

Barra

et al. 2015

Rev. méd. Chile

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Section: Discussionunclassified

Influencia de la ganancia de peso durante el primer año del trasplante renal en la sobrevida de injertos y pacientes

Vega

Barra

et al. 2015

Rev. méd. Chile

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“…Renal transplantation is an important option for treating patients with end-stage chronic renal disease. Anti-human leukocyte antigen (HLA) antibodies may be produced due to alloimmunization factors (blood transfusion, pregnancy, or organ transplantation) (1,2) .…”

Section: Introductionmentioning

confidence: 99%

The Assessment of HLA Sensitization Effect on Graft Function and Survival in Renal Transplant Recipients

Güleç¹,

Ayna²,

Soyöz³

et al. 2021

Terh

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Objective: Anti-human leukocyte antibodies (HLA) play an important role in graft survival, particularly in kidney transplantation. Preformed anti-HLA antibodies, especially donor specific antibodies can cause acute and chronic rejections. In this study, it was aimed to assess the effects of anti-HLA antibodies in kidney patients before transplant on graft function, failure, and patient survival. Methods: PRA (Panel Reactive Antibody) levels were monitored using bead based methods such as Luminex and flow cytometry. Post-transplant estimated glomerular filtration ratios (eGFR) among first, third, and fifth year patient survivals and graft failures were statistically analyzed. Results: In this study, it was observed that related transplants had low levels of PRAs, and their eGFRs were at normal reference range. The patients without acute rejection episode (ARE) had higher eGFR values than those with ARE. When five year-graft survival terms were evaluated, it was found that 65.6±9.8% and 86.5±3.2% graft survival terms were detected in anti-HLA Class I/II positive and negative patients, whereas 74.8±6.4% and 84.3 ±2.6% graft survival terms were observed in ARE positive and negative patients, respectively. eGFR value is a predictor of graft failure and patient survival. Our Cox regression analyses (HR=0.843, p=0.00) also supported this information. Conclusion: The study concluded that although the correlation between PRA positivity and graft survival were not significant, the shortest graft survival was observed in PRA positive patients in the whole cohort and ARE positive patients. The importance and requirement of pre- and post-transplant PRA tests continue.

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“…Moreover, it has been associated with proteinuria and reduced glomerular filtration rate (GFR) , suggesting a link with chronic kidney disease (CKD). Diabetes mellitus (DM), CVD, and proteinuria are all often observed after renal transplantation, and recently, MS has attracted a great deal of interest in the kidney transplant setting .…”

Section: Introductionmentioning

confidence: 99%

“…Currently, employed immunosuppressive agents are associated with increment in the incidence and severity of traditional cardiovascular risk factors, mainly obesity, hypertension, diabetes mellitus, and dyslipidemia. Moreover, in kidney transplant recipients, the MS has been shown to be associated with CVD and post‐transplant diabetes mellitus (PTDM), deteriorating graft function and graft loss .…”

Section: Introductionmentioning

confidence: 99%

Effects of metabolic syndrome on kidney transplantation outcomes: a systematic review and meta-analysis

et al. 2016

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Metabolic syndrome (MS) has been associated with proteinuria and reduced glomerular filtration rate. Immunosuppressive agents increase the incidence of traditional risk factors for cardiovascular disease (CVD) and have known effects on MS components after kidney transplantation. The purpose of this meta-analysis was to evaluate the impact of MS on relevant outcomes after kidney transplantation. MEDLINE, EMBASE, and Cochrane Library were searched up to November 7, 2015. Papers that compared patients with and without MS and assessed one of the following outcomes, graft loss, death by cardiovascular disease, and all-cause mortality, were included. Of 585 studies identified, five studies including 1269 patients were evaluated. MS was identified as a risk factor for graft loss [relative risk, 3.06; 95% confidence interval (CI), 2.17, 4.32; I² = 0%; P heterogeneity = 0.72] and death by CVD (relative risk, 3.53; 95% CI, 1.27, 9.85; I² = 0%; P heterogeneity = 0.40). Results on the association between MS and all-cause mortality were inconclusive (relative risk, 2.61; 95% CI, 0.70, 9.81; I² = 58%; P heterogeneity = 0.09). Graft loss and death by CVD were associated with the presence of MS after transplantation. Randomized clinical trials should be conducted to define whether interventions on each MS component would result in better outcomes after transplantation.

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Evaluation of metabolic syndrome and associations with inflammation and graft function in renal transplant recipients

Abstract: In RTR there is a significant association among MS and inflammation. MS is negatively associated with graft function. The clinical implications of these findings must be evaluated in longitudinal studies.

Cited by 7 publications

References 42 publications

Influencia de la ganancia de peso durante el primer año del trasplante renal en la sobrevida de injertos y pacientes

Influencia de la ganancia de peso durante el primer año del trasplante renal en la sobrevida de injertos y pacientes

The Assessment of HLA Sensitization Effect on Graft Function and Survival in Renal Transplant Recipients

Effects of metabolic syndrome on kidney transplantation outcomes: a systematic review and meta-analysis

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