Functional and histopathologic changes in renal transplant patients with new-onset diabetes and dyslipidemia

B. Borda, E. Szederkényi, C. Lengyel, Z. Morvay, J. Eller, F. Marofka, V. Szabó, T. Takács, P. Szenohradszky, Z. Hódi, G. Lazar

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Abstract

Background: The principal risk factors for cardiovascular mortality posttransplantation are hyperglycemia, hypertriglyceridemia, obesity, and smoking. Methods: Among 115 patients, we assessed the risk factors for new-onset diabetes (NODM) and dyslipidemia (NODL), and their effects on the function and histopathologic changes in the allografts at 1 year posttransplantation. Results: When evaluating the risk factors and the initial recipient data, we observed a significant difference in age when comparing normal vs NODM patients (P = .004), normal versus NODL patients (P = .002), and normal versus NODL + NODM patients (P = .0001). The difference in body mass index (BMI) was significant when comparing normal with NODM + NODL patients (P = .003). In regard to immunosuppressive therapy, NODM was significantly more frequent among/prescribed tacrolimus (tac; P = .005), whereas subjects who received cyclosporine (CsA) showed a significantly higher incidence of NODL (P = .001). The triglyceride levels were 3.02 ± 1.51 mmol/L among those on CsA versus 2.15 ± 1.57 mmol/L for (P = .004). The difference also proved to be significant for total cholesterol level: 5.43 ± 1.23 mmol/L versus 4.42 ± 1.31 mmol/L respectively (P = .001). In regard to allograft function a significant difference was noted at 1 year after transplantation between the NODM + NODL and the normal group in serum creatinine level (P = .02) as well as the estimated glomerular filtration rate (P = .004). Among diabetic patients, the serum creatinine level measured at posttransplant year 5 was significantly higher than that in 1 year (212.43 vs 147.00 μmol/L; P = .0003). When assessing morphologic changes in the kidney, we observed significantly more frequent interstitial fibrosis/tubular atrophy in all 3 groups compared with normal function patients. Conclusion: Our clinical study suggested that at 1 year after transplantation allograft function is already impaired in the presence of both medical conditions (NODM and NODL). However, in regard to morphology, a single condition (NODM or NODL) was sufficient to produce histologic changes in the kidney.

Original languageEnglish
Pages (from-to)1254-1258
Number of pages5
JournalTransplantation Proceedings
Volume43
Issue number4
DOIs
Publication statusPublished - May 2011

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Dyslipidemias
Transplants
Kidney
Allografts
Creatinine
Transplantation
Hypertriglyceridemia
Tacrolimus
Immunosuppressive Agents
Serum
Glomerular Filtration Rate
Hyperglycemia
Cyclosporine
Atrophy
Triglycerides
Body Mass Index
Fibrosis
Obesity
Smoking
Cholesterol

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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Functional and histopathologic changes in renal transplant patients with new-onset diabetes and dyslipidemia. / Borda, B.; Szederkényi, E.; Lengyel, C.; Morvay, Z.; Eller, J.; Marofka, F.; Szabó, V.; Takács, T.; Szenohradszky, P.; Hódi, Z.; Lazar, G.

In: Transplantation Proceedings, Vol. 43, No. 4, 05.2011, p. 1254-1258.

Research output: Contribution to journalArticle

Borda, B. ; Szederkényi, E. ; Lengyel, C. ; Morvay, Z. ; Eller, J. ; Marofka, F. ; Szabó, V. ; Takács, T. ; Szenohradszky, P. ; Hódi, Z. ; Lazar, G. / Functional and histopathologic changes in renal transplant patients with new-onset diabetes and dyslipidemia. In: Transplantation Proceedings. 2011 ; Vol. 43, No. 4. pp. 1254-1258.
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AU - Borda, B.

AU - Szederkényi, E.

AU - Lengyel, C.

AU - Morvay, Z.

AU - Eller, J.

AU - Marofka, F.

AU - Szabó, V.

AU - Takács, T.

AU - Szenohradszky, P.

AU - Hódi, Z.

AU - Lazar, G.

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N2 - Background: The principal risk factors for cardiovascular mortality posttransplantation are hyperglycemia, hypertriglyceridemia, obesity, and smoking. Methods: Among 115 patients, we assessed the risk factors for new-onset diabetes (NODM) and dyslipidemia (NODL), and their effects on the function and histopathologic changes in the allografts at 1 year posttransplantation. Results: When evaluating the risk factors and the initial recipient data, we observed a significant difference in age when comparing normal vs NODM patients (P = .004), normal versus NODL patients (P = .002), and normal versus NODL + NODM patients (P = .0001). The difference in body mass index (BMI) was significant when comparing normal with NODM + NODL patients (P = .003). In regard to immunosuppressive therapy, NODM was significantly more frequent among/prescribed tacrolimus (tac; P = .005), whereas subjects who received cyclosporine (CsA) showed a significantly higher incidence of NODL (P = .001). The triglyceride levels were 3.02 ± 1.51 mmol/L among those on CsA versus 2.15 ± 1.57 mmol/L for (P = .004). The difference also proved to be significant for total cholesterol level: 5.43 ± 1.23 mmol/L versus 4.42 ± 1.31 mmol/L respectively (P = .001). In regard to allograft function a significant difference was noted at 1 year after transplantation between the NODM + NODL and the normal group in serum creatinine level (P = .02) as well as the estimated glomerular filtration rate (P = .004). Among diabetic patients, the serum creatinine level measured at posttransplant year 5 was significantly higher than that in 1 year (212.43 vs 147.00 μmol/L; P = .0003). When assessing morphologic changes in the kidney, we observed significantly more frequent interstitial fibrosis/tubular atrophy in all 3 groups compared with normal function patients. Conclusion: Our clinical study suggested that at 1 year after transplantation allograft function is already impaired in the presence of both medical conditions (NODM and NODL). However, in regard to morphology, a single condition (NODM or NODL) was sufficient to produce histologic changes in the kidney.

AB - Background: The principal risk factors for cardiovascular mortality posttransplantation are hyperglycemia, hypertriglyceridemia, obesity, and smoking. Methods: Among 115 patients, we assessed the risk factors for new-onset diabetes (NODM) and dyslipidemia (NODL), and their effects on the function and histopathologic changes in the allografts at 1 year posttransplantation. Results: When evaluating the risk factors and the initial recipient data, we observed a significant difference in age when comparing normal vs NODM patients (P = .004), normal versus NODL patients (P = .002), and normal versus NODL + NODM patients (P = .0001). The difference in body mass index (BMI) was significant when comparing normal with NODM + NODL patients (P = .003). In regard to immunosuppressive therapy, NODM was significantly more frequent among/prescribed tacrolimus (tac; P = .005), whereas subjects who received cyclosporine (CsA) showed a significantly higher incidence of NODL (P = .001). The triglyceride levels were 3.02 ± 1.51 mmol/L among those on CsA versus 2.15 ± 1.57 mmol/L for (P = .004). The difference also proved to be significant for total cholesterol level: 5.43 ± 1.23 mmol/L versus 4.42 ± 1.31 mmol/L respectively (P = .001). In regard to allograft function a significant difference was noted at 1 year after transplantation between the NODM + NODL and the normal group in serum creatinine level (P = .02) as well as the estimated glomerular filtration rate (P = .004). Among diabetic patients, the serum creatinine level measured at posttransplant year 5 was significantly higher than that in 1 year (212.43 vs 147.00 μmol/L; P = .0003). When assessing morphologic changes in the kidney, we observed significantly more frequent interstitial fibrosis/tubular atrophy in all 3 groups compared with normal function patients. Conclusion: Our clinical study suggested that at 1 year after transplantation allograft function is already impaired in the presence of both medical conditions (NODM and NODL). However, in regard to morphology, a single condition (NODM or NODL) was sufficient to produce histologic changes in the kidney.

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