Improved cardiovascular risk profile of patients with type 1 diabetes mellitus and renal failure after simultaneous pancreas-kidney transplantation.
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.
Tamajón
L Pérez
LP
Servicio de Nefrología, Hospital Universiterio de Canarias, La Laguna, Tenerife, Spain. lptamajon@terra.es
Miranda
D Marrero
DM
Figueroa
A Caballero
AC
Marrero
D Hernández
DH
Cerdeña
I Laynez
IL
Gutiérrez
A Bravo
AB
Fernández
M Meneses
MM
Hernández
A Alarcó
AA
Herrera
L Morcillo
LM
González-Posada Delgado
J M
JM
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
D006442:Glycated Hemoglobin; D008074:Lipoproteins; D014280:Triglycerides