Effects of metabolic syndrome on kidney transplantation outcomes: a systematic review and meta-analysis.
Metabolic syndrome (MS) has been associated with proteinuria and reduced glomerular filtration rate. Immunosuppressive agents increase the incidence of traditional risk factors for cardiovascular disease (CVD) and have known effects on MS components after kidney transplantation. The purpose of this meta-analysis was to evaluate the impact of MS on relevant outcomes after kidney transplantation. MEDLINE, EMBASE, and Cochrane Library were searched up to November 7, 2015. Papers that compared patients with and without MS and assessed one of the following outcomes, graft loss, death by cardiovascular disease, and all-cause mortality, were included. Of 585 studies identified, five studies including 1269 patients were evaluated. MS was identified as a risk factor for graft loss [relative risk, 3.06; 95% confidence interval (CI), 2.17, 4.32; I² = 0%; P heterogeneity = 0.72] and death by CVD (relative risk, 3.53; 95% CI, 1.27, 9.85; I² = 0%; P heterogeneity = 0.40). Results on the association between MS and all-cause mortality were inconclusive (relative risk, 2.61; 95% CI, 0.70, 9.81; I² = 58%; P heterogeneity = 0.09). Graft loss and death by CVD were associated with the presence of MS after transplantation. Randomized clinical trials should be conducted to define whether interventions on each MS component would result in better outcomes after transplantation.
Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Elis F
EF
Pedrollo
Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Camila
C
Corrêa
Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Bruna B
BB
Nicoletto
Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.|Department of Internal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.|Division of Nephrology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Roberto C
RC
Manfro
Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.|Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Cristiane B
CB
Leitão
Department of Nutrition, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.|Division of Nutrition, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Gabriela C
GC
Souza
Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. lfgoncalves@hcpa.edu.br.|Department of Internal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. lfgoncalves@hcpa.edu.br.|Division of Nephrology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. lfgoncalves@hcpa.edu.br.
Luiz Felipe S
LF
Gonçalves
D000328:Adult; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000401:mortality*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000401:mortality*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012307:Risk Factors
D007166:Immunosuppressive Agents
death by cardiovascular disease; graft loss; kidney transplantation; metabolic syndrome