Metabolic Syndrome in Kidney Transplantation

Abstract

The metabolic syndrome is a constellation of clinical abnormalities related to insulin resistance and inflammation. The syndrome is now recognized as a risk factor for diabetes and cardiovascular disease in the general population. Recent studies suggest that the metabolic syndrome is common after kidney transplantation, also possibly being predictive of allograft loss and poor allograft function. The development or worsening of obesity plays a central role in the development of metabolic syndrome after kidney transplantation. Immunosuppression also plays an important role in the pathogenesis of the individual components of the metabolic syndrome. In fact, the overriding influence of immunosuppressive medications makes it unclear whether the metabolic syndrome has the same value in predicting outcomes as is true in the general population. However, recent studies suggest that the presence of metabolic syndrome before transplantation predicts the subsequent development of new-onset diabetes after transplantation, independent of other widely known risk factors. Aggressive management of the metabolic syndrome is warranted both before and after transplantation.

Paediatric obesity and renal transplantation: current challenges and solutions

“…Several adult studies have suggested that the presence of the metabolic syndrome is a potent predictor of patient and graft outcome [44,45] and that obesity is the primary pathology responsible for the development of the metabolic syndrome [4,[45][46][47][48], particularly as adipose tissue secretes adipokines, such as leptin, tumor necrosis factor alpha and interleukin-6 [49]. It is unsurprising, therefore, to see that the prevalence of the metabolic syndrome in children increases following transplantation, affecting between 20 and 40 % of individuals in the first 1-2 years post-transplantation, particularly with prolonged corticosteroid use [50,51].…”

Response to “Laparoscopic Sleeve Gastrectomy as a Weight Reduction Strategy in Obese Patients After Kidney Transplantation“

“…First, as described in a review by Hricik, weight gain after kidney transplantation is common and occurs in a majority of recipients (2). There are several mechanisms that could explain this phenomenon, including the effect of immunosuppressive agents and the diet change due to the cessation of dialysis treatment (3).…”

Evolução do peso durante o primeiro ano de transplante renal e a ocorrência de Diabetes Mellitus após 5 anos de seguimento

“…1 , e, quando bem sucedido, proporciona melhor qualidade de vida em comparação com outros métodos dialíticos, contribuindo para o aumento da expectativa de vida e também beneficiando os pacientes nas esferas psicológica e emocional [2][3][4][5] . Esta modalidade de TRS apresenta números crescentes 6 .…”