Metabolic syndrome in hemodialysis patients as a risk factor for new-onset diabetes mellitus after renal transplant: a prospective observational study

Abstract

PurposeMetabolic syndrome is a cluster of biochemical abnormalities including cardiovascular and diabetes risk factors. The development of diabetes mellitus after renal transplant represents a major posttransplant complication that may adversely affect graft/patient survival. The aim of this study was to assess the role of metabolic syndrome in patients on hemodialysis as a risk factor for the incidence of new-onset diabetes mellitus after renal transplant.Patients and methodsThis was a prospective observational epidemiologic study carried out in adult nondiabetic patients undergoing chronic hemodialysis and on the renal transplant waiting list between November 2008 and April 2009. Patients were followed up from Visit 1 (baseline) to 6 months after the renal transplant. The analysis of the role of metabolic syndrome in hemodialysis patients as a risk factor for the incidence of new-onset diabetes mellitus after renal transplant included the estimation of relative risk and its 95% confidence interval (CI).ResultsA total of 383 evaluable patients were entered into the study (mean age, 52.7 years; male, 57.7%; Caucasian, 90.1%). The prevalence of metabolic syndrome on hemodialysis was 30.4% (95% CI, 25.8%–35.4%). Hypertension was the most prevalent criterion for metabolic syndrome (65.0%), followed by low levels of high-density lipoprotein cholesterol (52.7%), abdominal obesity (36.2%), hypertriglyceridemia (32.4%), and impaired glucose (8.9%). After the renal transplant, the prevalence of metabolic syndrome was still 25.8%. During the posttransplant period, the incidence of new-onset diabetes mellitus reached 13.0% (95% CI, 7.8%–20.6%) and patients with pretransplant metabolic syndrome were 2.6 times (95% CI, 1.043–6.608) more likely to develop new-onset diabetes mellitus after the renal transplant than those without metabolic syndrome.ConclusionThe presence of metabolic syndrome in patients undergoing hemodialysis represents an independent risk factor for the incidence of new-onset diabetes mellitus after renal transplant.

Prevalence of Metabolic Syndrome and Associated Factors among Hemodialysis Patients Monitored at the National Teaching Hospital, Hubert Koutoucou Maga in 2015

“…Metabolic syndrome prevalence among hemodialysis patients was 27.9% in Spain and Russia while similar results were reported by Perez and Radojica [8] [15]. In their studies, metabolic syndrome prevalence was respectively 29% and 29.8% in hemodialysis patients [8] and 34.3% [11] [16]. In UCAR study, metabolic syndrome prevalence based on IDF criteria was 36% [17].…”

“…This prevalence within hemodialysis population may reach 70% [10]. Metabolic syndrome triples the risk of developing cardiovascular disease [9] [11], and increases two-fold mortality among hemodialysis patients [12].…”

Impact of Metabolic Disturbances and Malnutrition‐Inflammation on 6‐Year Mortality in Japanese Patients Undergoing Hemodialysis

“…Possible explanations for the discrepancies among these studies are differences in the study populations, inclusion criteria, dialysis method, confounding influences of covariates, and different retention of the various adiponectin isoforms in patients with residual kidney function. Interestingly, a recent study about metabolic syndrome in patients undergoing HD as a risk factor for new‐onset diabetes mellitus after renal transplant was reported . Therefore, further prospective investigations are required to confirm the role of metabolic disturbances in patients undergoing HD.…”

Metabolic syndrome in haemodialysis patients: Prevalence, determinants and association to cardiovascular outcomes

“…However, MetS and diabetes have been closely associated, both in the general population (13) and in dialysis patients. It has also been shown that the risk of post-transplant diabetes is associated with the presence of MetS in pre-transplantation (14).…”