Clinical diagnosis of metabolic syndrome: predicting new-onset diabetes, coronary heart disease, and allograft failure late after kidney transplant

Transplant International, 05/01/2012

Metabolic syndrome, new–onset diabetes after kidney transplant (NODAT), and coronary heart disease (CHD) are risk factors for allograft failure. NODAT and CHD are risk factors for allograft failure, independent of metabolic syndrome.

Methods

  • Using data collected from transplant centers worldwide for the Patient Outcomes in Renal Transplantation study, they examined associations of metabolic syndrome (n = 2253 excluding recipients with diabetes pretransplant), CHD (n = 2253), and NODAT (n = 1840 further excluding recipients with diabetes in the first year post-transplant), with the primary outcome of allograft failure.
  • Authors assessed risk factors associated with secondary outcomes of metabolic syndrome, NODAT, and CHD after adjusting for type of baseline immunosuppression and transplant center effects.

Results

  • Metabolic syndrome prevalence was 39.8% at 12–24 months post-transplant and 35.4% at 36–48 months.
  • Metabolic syndrome was independently associated with NODAT (hazard ratio 3.46, 95% confidence interval 2.40–4.98, P < 0.0001), CHD (2.03, 1.16–3.52, P = 0.013), and allograft failure (1.36, 1.03–1.79, P = 0.028).
  • Allograft failure occurred in 218 patients (14.6%).
  • After adjustment for metabolic syndrome, NODAT (1.63, 1.18–2.24, P = 0.003) and CHD (5.48, 3.27–9.20, P < 0.0001) remained strongly associated with increased risk of allograft failure.

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