Assessing the Prevalence of Metabolic Syndrome in Renal Transplantation
Condition: Chronic Renal Failure (CRF); Renal Transplantation
MeSH terms: Kidney Failure, Chronic; Metabolic Syndrome
Study type: Observational

Summary: 
      Metabolic syndrome (MS) is characterized by a series of metabolic and hemodynamic parameters
      such as hypertension (hypertension), abdominal obesity, dyslipidemia, abnormal glucose
      metabolism and insulin resistance, resulting in increased cardiovascular morbidity and
      mortality and the risk for developing type 2 diabetes mellitus (T2DM). Metabolic syndrome is
      a common event after renal transplantation. The prevalence of MS increases post-transplant
      with weight gain. In renal transplant recipients, the SM is associated with CVD, diabetes
      after transplantation, worsening renal function and graft loss. Immunosuppressant medications
      have primary effect on the pathophysiology of MS. Several studies have evaluated the
      prevalence and impact of metabolic syndrome in renal transplant recipients as obesity,
      hypertension, dyslipidemia and use of immunosuppressants. The objectives of this study are to
      determine whether the determination of the metabolic syndrome at 6 months predicts this same
      condition at 12 months, determine the prevalence of metabolic syndrome at 12 months, to
      assess the prevalence of obesity and overweight in this population and to assess the
      prevalence of diabetes mellitus after renal transplantation. Patients who meet the inclusion
      criteria and did not meet the exclusion criteria will be invited to participate in the study,
      signing the Instrument of Consent (IC) and informed about the objectives and procedures of
      the study to be performed, with age between 18 and 60 years, both sexes, renal transplant
      recipients Renal Transplant Unit, Hospital das Clinicas, FMUSP living donor or deceased and
      use of immunosuppressive regimen consisting of tacrolimus, mycophenolate sodium and
      prednisone. Sampling will be conducted laboratory tests, filling out questionnaires on
      quality of life and anthropometric measures.
    

Detailed description: 
      Metabolic syndrome ( MS) is characterized by the presence of a number of metabolic and
      hemodynamic disorders such as hypertension (HBP ) , abdominal obesity , dyslipidemia,
      abnormal glucose metabolism and insulin resistance , resulting in increased cardiovascular
      morbidity and mortality and the risk for developing type 2 diabetes mellitus.

      The concept of metabolic syndrome (MS ) was first described by Reaven in 1988 as a
      combination of obesity , dyslipidemia , hypertension and fasting hyperglycemia , insulin
      resistance and inflammation as common pathophysiological disorders in cardiovascular disease
      (CVD). But the first comprehensive definition of MS was established only in 1998 , the World
      Health Organization ( WHO ) , in order to facilitate research in this area and points as a
      key indicator of SM the presence of hyperglycemia and / or resistance to insulin associated
      with days or more metabolic abnormalities (hypertension, dyslipidemia , obesity, and
      microalbuminuria).

      In the general population , the presence of MS is associated with increased risk of
      developing diabetes mellitus ( DM ) and cardiovascular disease . Some studies have associated
      the SM to the appearance of proteinuria and reduction in the value of the glomerular
      filtration rate ( GFR ), suggesting an association SM with chronic kidney disease ( CKD ) .

      Metabolic syndrome (MS) consists of complex disorder that involves assembly cardiovascular
      risk factors related to abdominal fat deposition and insulin resistance . MS is associated
      with cardiovascular disease , increasing overall mortality by about 1.5 times and
      cardiovascular mortality by about 2.5 times.

      In 2001 , the National Cholesterol Education Program - Panel of the National Cholesterol
      Education Program ( NCEP - ATP III ), prepared another proposal. According to the NCEP ATP
      III, SM represents the combination of at least three components.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients will be selected by examining the clinical records of Renal Transplant Service,
        Hospital das Clinicas, Faculty of Medicine, University of São Paulo (HCFMUSP). Patients who
        meet the inclusion criteria and did not meet the exclusion criteria will be invited to
        participate in the study, signing the Instrument of Consent (IC) and informed about the
        objectives and procedures of the study to be performed.
      
Keywords: Metabolic syndrome; Renal transplantation