Posttransplant metabolic complications in living-related renal allograft recipients of Kashmir Valley.
OBJECTIVE
Renal transplant offers a definitive therapeutic modality for patients with end-stage renal disease; however, 50% to 70% of these patients have graft dysfunction after the transplant. Proactive prevention management of metabolic complications may reduce posttransplant morbidity and mortality in these patients.


METHODS
A retrospective and prospective review of 120 kidney transplant recipients during 5 years' follow-up was performed to analyze the incidence and status of the various metabolic complications after a renal transplant.


RESULTS
In our study, postrenal transplant diabetes mellitus was seen in 9 of 120 patients (7.5%). The incidence of posttransplant diabetes mellitus was 5% in tacrolimus-treated patients (n=6) compared with 2.5% in cyclosporine-treated patients (n=3). Dyslipidemia, as hypercholesterolemia and hyper-triglyceridemia, was seen in 31 recipients (25.83%). Significant posttransplant hyperlipidemia was documented (P < .05). Further, it was noted that 25 patients who developed hyperlipidemia (20.83%) were taking cyclosporine-based therapy, while 6 were treated with tacrolimus-based therapy (5%; P < .05). However, most subjects with hyperlipidemia had renal graft dysfunction. Posttransplant erythrocytosis affected 9 renal transplant recipients (7.5%) with a mean (±SD) hematocrit of 41.3%±6.7%. A statistically significant correlation was seen between prerenal and postrenal transplant hematocrit by 12 months. Hyperparathyroidism was observed in 1 renal transplant patient (1.25%).


CONCLUSIONS
On the basis of this study, we conclude that posttransplant diabetes mellitus occurred in 7.5% patients, hypercholesteremia and hyper-triglyceridemia occurred in 25.83% patients, posttransplant erythrocytosis affected 7.5% patients, and hyperparathyroidism occurred in 1 renal transplant patient (1.25%). Moreover, dyslipidemia, contributed to progressive graft dysfunction.
Department of Immunology & Molecular Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar 190011, Kashmir, India.
Irfan A
IA
Shera
Qayser
Q
Yousuf
Mushtaq A
MA
Mir
Imtiyaz A
IA
Wani
M Saleem
MS
Najar
D000328:Adult; D064591:Allografts; D015415:Biomarkers / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D050171:Dyslipidemias / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006400:Hematocrit; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D007194:India / Q000453:epidemiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011086:Polycythemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D066027:Transplant Recipients; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers; D007166:Immunosuppressive Agents