Metabolic syndrome in kidney transplant recipients
Authors:
Karol Graňák 1; Matej Vnučák 1; Monika Beliančinová 1; Margaréta Pytliaková 2; Ivana Dedinská 1
Authors‘ workplace:
Chirurgická klinika a transplantačné centrum JLF UK a UNM, Martin
1; Centrum péče o zažívací trakt, Nemocnice AGEL Ostrava-Vítkovice a. s.
2
Published in:
Forum Diab 2021; 10(3): 187-192
Category:
Overview
Metabolic syndrome in kidney transplant recipients shares many common characteristics with the general population, but the presence of transplant-specific aspects (particularly the use of chronic immunosuppressive therapy) ranks this group of patients at high risk for its development. According to a previous analysis of the Transplant Center in Martin in 2016, its prevalence was found to be 44.4 %. The onset of metabolic syndrome in the post-transplant period is associated with impaired graft function and graft loss. Number of these patients suffer from metabolic syndrome, or its components, before transplantation, and even then it represents a significant risk factor for post-transplant diabetes mellitus, which is a serious metabolic complication with an impact on overall and cardiovascular morbidity and mortality. The most important step is prevention be selecting high-risk patients before transplantation and, in case of metabolic syndrome detection, active modification of lifestyle and treatment of its components in order to eliminate negative effects on the patient and the transplanted kidney.
Keywords:
kidney transplantation – metabolic syndrome – immunosuppression
Sources
1. Swarup S, Zelster R. Metabolic Syndrome. [Updated 2021 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing: 2021.
2. Saklayen MG. The Global Epidemic of the Metabolic Syndrome. Curr Hypertens Rep 2018;20(2): 12. Dostupné z DOI: <http://dx.doi.org/10.1007/s11906–018–0812-z>.
3. Chen G, Gao L, Li X et al. Effects of exercise training on cardiovascular risk factors in kidney transplant recipients: a systematic review and meta-analysis. Ren Fail 2019; 41(1): 408–418. Dostupné z DOI: <http://dx.doi.org/10.1080/0886022X.2019.1611602>.
4. Courivaud C, Kazory A, Simula-Faivre D et al. Metabolic syndrome and atherosclerotic events in renal transplant recipients. Transplantation 2007; 83(12): 1577–1581. Dostupné z DOI: <http://dx.doi.org/10.1097/01.tp.0000266898.93894.3d>.
5. Porrini E, Delgado P, Bigo C et al. Impact of metabolic syndrome on graft function and survival after cadaveric renal transplantation. Am J Kidney Dis 2006; 48(1): 134–142. Dostupné z DOI: <http://dx.doi.org/10.1053/j.ajkd.2006.04.078>.
6. Perdrollo E, Correa C, Nicoletto BB et al. Effects of metabolic syndrome on kidney transplantation outcomes : a systematic review and meta-analysis. Transpl Int 2016; 29(10): 1059–1066. Dostupné z DOI:<http://dx.doi.org/10.1111/tri.12805>.
7. Cai R, Wu M, Wing Y et al. Pretransplant metabolic syndrome and its components predict post-transplantation diabetes mellitus in Chinese patients receiving a first renal transplant. Ther Clin Risk Manag 2019; 15: 497–503. Dostupné z DOI: <http://dx.doi.org/10.2147/TCRM.S190185>.
8. Sharif A, Hecking M, de Vries J et al. Proceedings from an international consensus meeting on posttransplantation diabetes mellitus: recommendations and future directions. Am J Transplant 2014; 14(9): 1992–2000. Dostupné z DOI: <http://dx.doi,org/10.1111/ajt.12850>.
9. Torres A, Hernández D, Moreso F et al. Randomized controlled trial assessing the impact of tacrolimus versus cyclosporine on the incidence of posttransplant diabetes mellitus. Kidney Int Rep 2018; 3(6): 1304–1315. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ekir.2018.07.009>.
10. Van Laecke S, Caluwe R, Huybrechts I et al. Effect of Magnesium Supplements on Insulin Secretion After Kidney Transplantation: A Randomized Controlled Trial. Ann Transplant 2017; 22: 524–531. Dostupné z DOI: <http://dx.doi.org/10.12659/aot.903439>.
11. Rodriguez-Rodriguez A, Trinanes J, Porrini E et al. Glucose homeostasis changes and pancreatic β‐cell proliferation after switching to cyclosporin in tacrolimus‐induced diabetes mellitus. Nefrologia 2015 ; 35(3): 264–272. Dostupné z DOI: <http://dx.doi.org/10.1016/j.nefro.2015.05.007>.
12. Trinanes J, Rodriguez-Rodriguez A, Brito-Casillas Y et al. Deciphering Tacrolimus-Induced Toxicity in Panreatic b Cells. Am J Transplant 2017; 17(11): 2829–2840. Dostupné z DOI: <http://dx.doi.org/10.1111/ajt.14323>
13. Johnston O, Rose C, Webster AC et al. Sirolimus is associated with new-onset diabetes in kidney transplant recipients.J Am Soc Nephrol 2008; 19(7): 1411–1418. Dostupné z DOI: <http://dx.doi.org/10.1681/ASN.2007111202>.
14. Sgambat K, Clauss S, Moudgil A et al. Cardiovascular effects of metabolic syndrome after transplantation: convergence of obesity and transplant-related factors. Clin Kidney J 2018; 11(1): 136–146. Dostupnéz DOI: <http://dx.doi.org/10.1093/ckj/sfx056>.
15. Delautre, A, Chantrel, F, Dimitrov Y et al. Metabolic syndrome in haemodialysis patients: prevalence, determinants and association to cardiovascular outcomes. BMC Nephrol 2020; 21(1):343. Dostupné z DOI: <http://dx.doi.org/10.1186/s12882–020–02004–3>.
16. Young DO, Lund RJ, Haynatzki G et al. Prevalence of the metabolic syndrome in an incident dialysis population. Hemodial Int 2007; 11(1): 86–95. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1542–4758.2007.00158.x>.
17. Bayer ND, Cochetti PT, Kumar MS et al. Association of metabolic syndrome with development of new-onset diabetes after transplantation. Transplantation 2010; 90(8): 861–866. Dostupné z DOI: <http://dx.doi.org/10.1097/TP.0b013e3181f1543c>.
18. Hricik DE. Metabolic syndrome in kidney transplantation: management of risk factors. Clin J Am Soc Nephrol 2011; 6(7): 1781–1785. Dostupné z DOI: <http://dx.doi.org/10.2215/CJN.01200211>.
19. Dedinská I, Miklušica J, Laca L et al. Transplantácia obličky a metabolická syndróm. Forum Diab 2016; 5(2): 94–98.
20. Dedinská I, Baltesová T, Beňa L et al. Incidence of Diabetes Mellitus After Kidney Transplantation in Slovakia: Multicentric, Prospective Analysis. Transplant Proc 2016; 48(10): 3292–3298. Dostupné z DOI:<http://dx.doi.org/10.1016/j.transproceed.2016.09.041>.
21. Piotti G, Gandolfini I, Paqlmisano A et al. Metabolic risk profile in kidney transplant candidates and recipients. Nephrol Dial Transplant 2019; 34(3): 388–400. Dostupné z DOI: <http://dx.doi.org/10.1093/ndt/gfy151>.
22. Chakkera HA, Weil EJ, Swanson CM et al. Pretransplant risk score for new-onset diabetes after kidney transplantation. Diabetes Care 2011; 34(10): 2141–2145. Dostupné z DOI: <http://dx.doi.org/10.2337/dc11–0752>.
23. Hecking M, Werzowa J, Haidinger M et al. Novel views on new-onset diabetes after transplantation: development, prevention and treatment. Nephrol Dial Transplant 2013; 28(3): 550–566. Dostupné z DOI: <http://dx.doi.org/10.1093/ndt/gfs583>.
24. AlShelleh S, AlAwwa I, Oweis A et al. Prevalence of metabolic syndrome in dialysis and transplant patients. Diabetes Metab Syndr Obes 2019; 12: 575–579. Dostupné z DOI: <http://dx.doi.org/10.2147/DMSO.S200362>.
25. Despres J, Lemieux I. Abdominal obesity and metabolic syndrome. Nature 2006; 444(7121): 881–887. Dostupné z DOI: <http://dx.doi.org/10.1038/nature05488>.
26. Dedinská I, Mäčková N, Kantárová D et al. Leptin – A new marker for development of post-transplant diabetes mellitus? J Diabetes Complications 2018; 32(9): 863–869. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jdiacomp.2018.07.002>.
27. de Vries AP, Bakker SJ, Bakker SJ et al. Metabolic syndrome is associated with impaired long-term renal allograft function; not all components contribute equally. Am J Transplant 2004; 4(10): 1675–1683. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1600–6143.2004.00558.x>.
28. Jenssen T, Hartmann A. Post-transplant diabetes mellitus in patients with solid organ transplants. Nat Rev Endocrinol 2019; 15(3): 172–188. Dostupné z DOI: <http://dx.doi.org/10.1038/s41574–018–0137–7>.
29. Jenssen T, Hartmann A. Emerging treatments for post-transplantation diabetes mellitus. Nat Rev Nephrol 2015; 11(8): 465–477. Dostupné z DOI: <http://dx.doi.org/10.1038/nrneph.2015.59>.
30. Eide IA, Halden TA, Hartmann A et al. Mortality risk in post-transplantation diabetes mellitus based on glucose and HbA1c diagnostic criteria. Transpl Int 2016; 29(5): 568–578. Dostupné z DOI: <http://dx.doi.org/10.1111/tri.12757>.
31. Sharif A, Moore R, Baboolal K et al. Influence of lifestyle modification in renal transplant recipients with postprandial hyperglycemia. Transplantation 2008; 85(3): 353–358. Dostupné z DOI: <http://dx.doi.org/10.1097/TP.0b013e3181605ebf>.
32. Carvalho EV, Reboredo MM, Gomes EP et al. Physical activity in daily life assessed by an accelerometer in kidney transplant recipients and hemodialysis patients. Transplant Proc 2014; 46(6): 1713–1717. Dostupné z DOI: <http://dx.doi.org/10.1016/j.transproceed.2014.05.019>.
33. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Chapter 3: Management of progression and complications of CKD. Kidney Int Suppl 2013; 3(1): 73–90. Dostupné z DOI: <http://dx.doi.org/10.1038/kisup.2012.66>.
34. KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney International 2021; 99(3 Suppl): S1-S87. Dostupné z DOI: <http://dx.doi.org/10.1016/j.kint.2020.11.003>.
35. Agarwal A, Prasad GV. Post-transplant dyslipidemia: Mechanisms, diagnosis and management. World J Transplant 2016; 6(1):125–134. Dostupné z DOI: <http://dx.doi.org/10.5500/wjt.v6.i1.125>.
36. Mikolasevic I, Žutelija M, Mavrinac V et al. Dyslipidemia in patients with chronic kidney disease: etiology and management. Int J Nephrol Renovasc Dis 2017; 10: 35–45. Dostupné z DOI: <http://dx.doi.org/10.2147/IJNRD.S101808>.
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