title: Graft loss risk in renal transplant recipients with metabolic syndrome: subgroup analyses of the ALERT trial.
abstract: BACKGROUND
  Several nonimmunologic risk factors for late renal graft loss (RGL) are also known components of metabolic syndrome (MS). We aimed to study MS as a risk factor for RGL. Also, the effect of statin treatment in reducing renal risk in renal transplant recipients (RTRs) with MS was studied.
  
  
  METHODS
  Nondiabetic RTRs (n=1,706) from the ALERT trial were followed for 7-8 years. MS was defined according to National Cholesterol Education Program Adult Treatment Panel III definition with waist girth replaced by BMI ≥30 (calculated as kg/m(2)). Renal end points included death-censored RGL and graft loss or doubling of serum creatinine.
  
  
  RESULTS
  During the follow-up, 284 patients experienced RGL, and there were 343 cases of graft loss or doubling of serum creatinine. Those with MS had increased risk for RGL (relative risk = 1.28, 95% confidence interval, 1.00-1.63; p=0.047), but not for the combined end point. After adjustment for other known and potential risk factors, MS was no longer associated with increased risk for RGL. The association between MS and RGL risk was attenuated once adjustment for creatinine was made. Statin treatment did not reduce the risk for renal end points in RTRs with or without MS.
  
  
  CONCLUSIONS
  MS had no independent association with RGL risk. Adjustment for renal function attenuated the association between MS and RGL.
authors: Department of Medical Sciences, Uppsala University, Uppsala, Sweden. inga.soveri@medsci.uu.se
authors: Inga
authors: I
authors: Soveri
authors: Sadollah
authors: S
authors: Abedini
authors: Hallvard
authors: H
authors: Holdaas
authors: Alan
authors: A
authors: Jardine
authors: Niclas
authors: N
authors: Eriksson
authors: Bengt
authors: B
authors: Fellström
mesh_terms: D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D004311:Double-Blind Method; D005229:Fatty Acids, Monounsaturated / Q000627:therapeutic use*; D005260:Female; D000077340:Fluvastatin; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007108:Immune Tolerance; D007211:Indoles / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D000077340:Fluvastatin; D003404:Creatinine