Journal Article

Metabolic cardiovascular syndrome after renal transplantation

Jøran Hjelmesæth, Anders Hartmann, Karsten Midtvedt, Svend Aakhus, Jean Stenstrøm, Lars Mørkrid, Thore Egeland, Hrafnkell Tordarson and Per Fauchald

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 16, issue 5, pages 1047-1052
Published in print May 2001 | ISSN: 0931-0509
Published online May 2001 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/16.5.1047
Metabolic cardiovascular syndrome after renal transplantation

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Background. Cardiovascular disease (CVD) is the major cause of death in renal transplant recipients. Traditional risk factors like hypertension, dyslipidaemia and diabetes mellitus are common, but cannot completely account for the high prevalence of CVD in this population. The aim of the present study was to assess whether post‐transplant glucose intolerance, defined as post‐transplant diabetes mellitus, impaired glucose tolerance, or impaired fasting glucose, is associated with metabolic disturbances known to increase risk of cardiovascular disease, similar to what has been observed in the general population.

Methods. One hundred and seventy‐three consecutive patients were prospectively examined 10 weeks after transplantation. An oral glucose tolerance test was completed in 167 patients. Questionnaires, medical records, and the results of various blood tests were used to evaluate a number of known cardiovascular risk factors in all patients.

Results. Glucose intolerance was present in about one‐half the recipients and was associated with age, a positive family history of ischaemic heart disease, acute rejection, higher levels of serum triglycerides, apolipoprotein B and 2‐h insulin, and lower levels of serum HDL cholesterol. After adjustment for age and sex, lower HDL cholesterol (P=0.005), higher serum triglycerides (P<0.001), apolipoprotein B (P=0.039) and 2‐h insulin (P<0.001) were still associated with post‐transplant glucose intolerance.

Conclusions. Ten weeks after renal transplantation glucose intolerance is associated with a clustering of cardiovascular risk factors and metabolic abnormalities, consistent with a post‐transplant metabolic cardiovascular syndrome.

Keywords: cardiovascular disease; cardiovascular metabolic syndrome; dyslipidaemia; post‐transplant diabetes mellitus; post‐transplant glucose intolerance; renal transplantation

Journal Article.  3580 words. 

Subjects: Nephrology

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