title: Metabolic risk factors and long-term graft function after paediatric renal transplantation.
abstract: The aim of this study was to evaluate metabolic risk factors and their impact on long-term allograft function in paediatric renal transplant (RTx) patients. We reviewed the medical records of 210 RTx patients who underwent transplantation at a median age of 4.5 years (range 0.7-18.2) and a median follow-up of 7.0 years (range 1.5-18.0). Data on lipid and glucose metabolism, uric acid levels, weight and blood pressure were collected up to 13 years post-RTx, and the findings were correlated with the measured glomerular filtration rate (GFR). Beyond the first year, GFR showed gradual deterioration with a mean decline of 2.4 ml/min/1.73 m(2)/year. Metabolic syndrome, overweight, hypertension and type 2 diabetes were diagnosed in 14-19%, 20-23%, 62-87% and 3-5% of the patients, respectively. These entities showed only mild association with the concomitant or long-term GFR values. Dyslipidaemia was common and hypertriglyceridaemia associated with a lower GFR at 1.5 and 5 years post-RTx (P = 0.008 and P = 0.017, respectively). Similarly, hyperuricaemia was frequent and associated significantly with GFR (P < 0.001). Except for hyperuricaemia and hypertriglyceridaemia, metabolic risk factors beyond the first postoperative year associated modestly with the long-term kidney graft function in paediatric RTx patients.
authors.affiliation: Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Juuso
authors.initials: J
authors.lastname: Tainio
authors.forename: Erik
authors.initials: E
authors.lastname: Qvist
authors.forename: Tuula
authors.initials: T
authors.lastname: Hölttä
authors.forename: Mikko
authors.initials: M
authors.lastname: Pakarinen
authors.forename: Timo
authors.initials: T
authors.lastname: Jahnukainen
authors.forename: Hannu
authors.initials: H
authors.lastname: Jalanko
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001774:Blood Chemical Analysis; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology* / Q000503:physiopathology*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
keywords: adolescents; children; glomerular filtration rate; metabolic syndrome; renal transplantation; risk factors