[Improved short-term cardiovascular profile after simultaneous pancreas-kidney transplantation].
The prognosis of type 1 diabetes mellitus (T1DM) patients with chronic renal failure (CRF) improves after simultaneous pancreas-kidney (SPK) transplantation. In order to evaluate the changes in cardio-vascular risk (CVR) factors after SKP, we studied nine recipients before and 6 months after SPK. There were five females and four males, with a mean age of 37 +/- 8 years, duration of diabetes of 24 +/- 5 years, three of them before starting dialysis, and six on dialysis (hemodialysis = 5; peritoneal dialysis = 1). Before SPK, all patients received anti-hypertensive therapy (1-4 drugs; mean 2.2 +/- 0.9) and eight received statins. At 6 months after SPK, all patients were under triple immunosuppressive therapy (steroids + tacrolimus + MMF) without statins. They had normal renal function (Plasma Creatinine = 1.2 +/- 0.3 mg/dl) and pancreatic endocrine function (glycemia = 80 +/- 8 mg/dl). HbA1c decreased significantly (8.4 +/- 1.2 vs 4.7 +/- 0.6%; p < 0.007) with a value > 7% in seven patients before SPK and in none 6 months after SKP transplantation (p < 0.001). Although Body Mass Index increased (23 +/- 2 vs 25 +/- 3 kg/m2; p < 0.05), plasma triglycerides decreased (130 +/- 51 vs 88 +/- 33 mg/dl; p < 0.05), and total cholesterol, LDL-cholesterol and HDL-cholesterol were similar. Systolic and diastolic blood pressure (BP) decreased (156 +/- 7 vs 133 +/- 15; p < 0.01 and 96 +/- 7 vs 79 +/- 9; p < 0.007) with only two patients on anti-hypertensive therapy (1 drug). Likewise, before transplantation all patients were hypertensive (six grade 1 and three grade 2) while this was observed in only two at the end of follow-up (both grade 1) (p < 0.001). In conclusion, SPK transplantation with good renal and pancreatic function is associated with a short-term improvement in CVR profile.
González-Posada
J M
JM
Servicio de Nefrología, Hospital Universitario de Canarias, Ofra, s/n,38230 Sta. Cruz de Tenerife, La Laguna. jmgposada@hotmail.com
Pérez Tamajón
L
L
Caballero
A
A
Laynez
I
I
Marrero
D
D
Rodríguez
C
C
Bravo
A
A
Meneses
M
M
Alarco
A
A
Morcillo
L
L
Hernández
D
D
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002319:Cardiovascular System / Q000503:physiopathology*; D048909:Diabetes Complications / Q000188:drug therapy / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D016035:Pancreas Transplantation; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents