Impact of Metabolic Syndrome on Graft Function and Survival After Cadaveric Renal Transplantation

Porrini, Esteban; Delgado, Patricia; Bigo, Celia; Alvarez, Alejandra; Cobo, Marian; Checa, María Dolores; Hortal, L; Fernández, Ana; Garcia, J.; Velázquez, Silvia; Hernández, Domingo; Salido, Eduardo; Torres, Armando

doi:10.1053/j.ajkd.2006.04.078

Cited by 130 publications

(118 citation statements)

References 22 publications

Supporting

Mentioning

101

Contrasting

Unclassified

Order By: Relevance

“…7 Porrini et al identified lower estimated GFR in renal transplant recipients from deceased donors in both the baseline (the end of the first year of transplantation) and at the end of follow-up (three years on average after the transplant). 4 In the present study, a single evaluation of GFR was performed at a median follow-up of 56 months, and there was no association between the occurrence of MS and worse renal graft function. This observation holds true even when we divide the sample into two groups, based on the median time of follow-up after transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…Hypertension represents the most common cardiovascular and renal risk factor, and it was found in 97. 4 and 87.5% of our renal transplant recipients with and without MS, respectively. Beta-blockers have been used to treat hypertension for decades, either as monotherapy or combined with other anti-hypertensive agents.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is important to recognize that the cross-sectional nature of this study cannot evaluate the possible negative impact of MS on graft renal function over time, as previously mentioned. 4,7 Besides, the use of creatinine or its blood clearance as surrogate endpoint may be misleading. Nankivell et al showed that renal allograft function may underestimate the histological development of chronic renal allograft dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…Porrini et al, in Spain, found MS in 37.7% of the patients. 4 In Japan, the prevalence of MS varied from 14.9 to 23.8%, according to the criteria used. 16 Moreover, in the Netherlands, 63% of the 606 renal transplant recipients evaluated presented MS. 7 A study in Brazil, to assess the prevalence of cardiovascular risk factors in renal transplantation, identified MS in 53% of the 192 patients studied.…”

Section: Discussionmentioning

confidence: 99%

“…3 The presence of MS increases the cardiovascular risk in the general population and in recipients of renal transplantation. 4 The population of patients undergoing renal transplantation is considered at high-risk for developing obesity and changes in lipid and glucose metabolism, due to the use of immunosuppressive drugs and increased food freedom in the post-transplant period. For instance, high incidence of post-transplant diabetes mellitus (PTDM) and MS was observed among kidney transplant recipients treated with tacrolimus as the main immunosuppressive medication.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Prevalência de síndrome metabólica e fatores associados em pacientes transplantados renais

Teixeira¹,

Fernandes²,

Mata³

et al. 2012

J. Bras. Nefrol.

View full text Add to dashboard Cite

Introduction: The population of patients undergoing renal transplantation is considered at highrisk for developing obesity and changes in lipid and glucose metabolism, due to the use of immunosuppressive drugs and increased food freedom in the post-transplant period. Objective: This study was designed to assess the prevalence of metabolic syndrome in renal transplant recipients and to identify factors associated with its occurrence. Methods: A cross-sectional study was performed in renal transplant patients, with more than six months of follow-up. The metabolic syndrome was diagnosed according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III. Results: Among the 87 patients enrolled, 39 (44.8%) presented the phenotype of metabolic syndrome. The mean age of the patients was 43.5 ± 12.1 years-old, with a predominance of male (69.0%) and white (66.7%). The mean and median times of post transplant follow-up were 64.2 ± 49.4 and 56 months, respectively. All the 12 patients who developed post-transplant diabetes mellitus also met the criteria for metabolic syndrome, which compromised the inclusion of this variable in the logistic regression. In the univariate analysis, patients with metabolic syndrome had higher mean age (p = 0.008), higher median blood level of cyclosporine (p = 0.021), higher prevalence of history of coronary disease (p = 0.023), and they were more frequent users of beta (p = 0.011) and calcium-channel blockers (p = 0.039). In the multivariate analysis, age (HR = 1.06; 95% CI=1.01-1.11, p=0.006) and use of beta-blockers (HR = 4.02; 95% CI = 1.41 -11.4, p = 0.009) were asso-ciated with increased

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prevalência de síndrome metabólica e fatores associados em pacientes transplantados renais

Teixeira¹,

Fernandes²,

Mata³

et al. 2012

J. Bras. Nefrol.

View full text Add to dashboard Cite

show abstract

Metabolic Risk Profile and Graft Function Deterioration 2 Years After Kidney Transplant

Yan,

Yang,

Wang

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceStudies exploring the association of body weight and metabolic status with graft function deterioration (GFD) after kidney transplantation have produced inconsistent findings. Few studies have examined whether metabolically healthy overweight or obesity (MHO) may contribute to GFD.ObjectiveTo evaluate associations of overweight or obesity and metabolic disorders with GFD in recipients of kidney transplant.Design, Setting, and ParticipantsThis multicenter retrospective cohort study was conducted from January 1, 2020, through June 30, 2021, with a follow-up period of 2 years after kidney transplantation. Participants included adult recipients of cadaveric kidney transplant in 4 transplantation centers in China. Participants were classified as 4 metabolic phenotypes according to their BMI and metabolic status. Data were analyzed from July to August 2023.ExposuresOverweight and obesity were characterized by body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 24 or greater. Metabolic disorder was identified by existence of a minimum of 2 of 4 conditions: hypertension, hyperglycemia, increased triglyceride, and decreased high-density lipoprotein cholesterol.Main Outcome and MeasuresThe main outcome was GFD, defined as a decrease in estimated glomerular filtration rate of at least 25% within 6 months to 2 years after transplant.ResultsA total of 1260 adult recipients of cadaveric kidney transplant (mean [SD] age, 43.97 [11.51] years; 755 [59.92%] male) were included in the study, and 127 (10.08%) participants experienced the primary outcome of GFD during follow-up. After accounting for confounding factors in multivariable analyses, overweight or obesity (odds ratio [OR], 1.64; 95% CI, 1.10-2.44; P = .02) and metabolic disorder (OR, 1.71; 95% CI, 1.12-2.63; P = .01) were associated with increased risk of GFD. The MHO subgroup exhibited a greater risk for GFD (OR, 2.37; 95% CI, 1.01-5.57; P = .048) compared with participants who did not have overweight or obesity or metabolic disorder. All components of metabolic disorder, with the exception of elevated triglyceride, were associated with GFD. There was a dose-response association of number of metabolic disorder components (OR per 1 additional condition, 1.40; 95% CI, 1.20-1.63; P &lt; .001) and BMI (OR per 1-unit increase, 1.90; 95% CI, 1.03-1.15; P = .002) with increased risk for GFD. A nonlinear association was observed between BMI and risk of GFD.Conclusions and RelevanceIn this cohort study of recipients of cadaveric kidney transplant, individuals with overweight or obesity or metabolic disorder had a significantly higher risk of experiencing GFD. Individuals with MHO had an elevated risk for graft function deterioration. Additional studies with larger sample size and longer follow-up are necessary to validate our findings.

show abstract

Definition, Diagnostic Criteria, Screening, Diagnosis, and Classification of Diabetes and Categories of Glucose Intolerance

Nandhini

Kamalanathan

Sahoo

2019

The Diabetes Textbook

View full text Add to dashboard Cite

Impact of Metabolic Syndrome on Graft Function and Survival After Cadaveric Renal Transplantation

Cited by 130 publications

References 22 publications

Prevalência de síndrome metabólica e fatores associados em pacientes transplantados renais

Prevalência de síndrome metabólica e fatores associados em pacientes transplantados renais

Metabolic Risk Profile and Graft Function Deterioration 2 Years After Kidney Transplant

Definition, Diagnostic Criteria, Screening, Diagnosis, and Classification of Diabetes and Categories of Glucose Intolerance

Contact Info

Product

Resources

About