title: Improved cardiovascular risk profile of patients with type 1 diabetes mellitus and renal failure after simultaneous pancreas-kidney transplantation.
abstract: BACKGROUND
  The prognosis of patients with type 1 diabetes mellitus and chronic renal failure improves after simultaneous pancreas-kidney (SPK) transplantation. Good control of glycemia and other cardiovascular risk factors may positively influence prognosis. The objective of this study was to evaluate changes in cardiovascular risk factors after SKP.
  
  
  METHODS
  We studied 13 patients (aged 36 +/- 8 years, 7 women) before and 12 months after SPK transplantation. All were treated with thymoglobulin, prednisone, tacrolimus, and mycophenolate mofetil. We compared the following pre- and post-SPK parameters: glycemia, HbA(1)c, total cholesterol, HDL, LDL, triglycerides, systolic (sBP), diastolic blood pressure (dBP), and body mass index (BMI).
  
  
  RESULTS
  Twelve months after SPK transplantation, glycemia, HbA(1)c and triglycerides significantly decreased (P < .001; P < .001, and P < .002, respectively), as did sBP (P < .002) and dBP (P < .001). No changes were found for BMI or total, HDL and LDL cholesterol values. The number of patients requiring antihypertensive therapy fell (13 versus 3; P < .002), as did the number of drugs (2.3 +/- 0.8 versus 0.4 +/- 0.7; P < .001). The number of patients requiring statins also fell (11 versus 3; P < .002). At 12 months, all patients had normal renal function (creatinine clearance 85 +/- 10 mL/min) and required no insulin; four had microalbuminuria.
  
  
  CONCLUSIONS
  These interim results show an improved cardiovascular risk profile 12 months after SPK transplantation, which lays the basis for a more favorable long-term prognosis.
authors.affiliation: Servicio de Nefrología, Hospital Universiterio de Canarias, La Laguna, Tenerife, Spain. lptamajon@terra.es
authors.forename: L Pérez
authors.initials: LP
authors.lastname: Tamajón
authors.forename: D Marrero
authors.initials: DM
authors.lastname: Miranda
authors.forename: A Caballero
authors.initials: AC
authors.lastname: Figueroa
authors.forename: D Hernández
authors.initials: DH
authors.lastname: Marrero
authors.forename: I Laynez
authors.initials: IL
authors.lastname: Cerdeña
authors.forename: A Bravo
authors.initials: AB
authors.lastname: Gutiérrez
authors.forename: M Meneses
authors.initials: MM
authors.lastname: Fernández
authors.forename: A Alarcó
authors.initials: AA
authors.lastname: Hernández
authors.forename: L Morcillo
authors.initials: LM
authors.lastname: Herrera
authors.forename: J M
authors.initials: JM
authors.lastname: González-Posada Delgado
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D011379:Prognosis; D040242:Risk Reduction Behavior; D014280:Triglycerides / Q000097:blood
chemical_list: D006442:Glycated Hemoglobin; D008074:Lipoproteins; D014280:Triglycerides