title: Functional and histopathologic changes in renal transplant patients with new-onset diabetes and dyslipidemia.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Szeged, Szeged, Hungary. bb@surg.szote.u-szeged.hu
authors.forename: B
authors.initials: B
authors.lastname: Borda
authors.forename: E
authors.initials: E
authors.lastname: Szederkényi
authors.forename: C
authors.initials: C
authors.lastname: Lengyel
authors.forename: Z
authors.initials: Z
authors.lastname: Morvay
authors.forename: J
authors.initials: J
authors.lastname: Eller
authors.forename: F
authors.initials: F
authors.lastname: Marofka
authors.forename: V
authors.initials: V
authors.lastname: Szabó
authors.forename: T
authors.initials: T
authors.lastname: Takács
authors.forename: P
authors.initials: P
authors.lastname: Szenohradszky
authors.forename: Z
authors.initials: Z
authors.lastname: Hódi
authors.forename: G
authors.initials: G
authors.lastname: Lázár
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001284:Atrophy; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D015992:Body Mass Index; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000009:adverse effects; D003920:Diabetes Mellitus / Q000097:blood / Q000209:etiology*; D050171:Dyslipidemias / Q000097:blood / Q000209:etiology*; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D006085:Graft Survival; D006801:Humans; D006814:Hungary; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007668:Kidney / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003404:Creatinine; D016572:Cyclosporine; D006442:Glycated Hemoglobin; D007166:Immunosuppressive Agents; D008055:Lipids; D016559:Tacrolimus; C517652:hemoglobin A1c protein, human