Metabolic syndrome in kidney transplant recipients with adverse cardiovascular events
Authors: Mitkovskaya N , Kalachyk A , Smaliakova M , Grigorenko E 
Published: October 2021

Abstract

Introduction
Kidney transplantation helps reduce cardiovascular mortality in patients receiving renal replacement therapy but the incidence of cardiovascular disorders in kidney transplant recipients remains significantly higher than in the general population. Metabolic syndrome is a combination of cardiovascular risk factors that can reinforce each other and increase the risk of cardiovascular disease and death in the general population.

Purpose
To study the incidence of the preceding metabolic syndrome in kidney transplant recipients with adverse cardiovascular events.

Methods
237 recipients six months after kidney transplantation were included in the study. 79 (33.3%) of them had adverse cardiovascular events during three years of observation. Other patients had no cardiovascular complications. The study groups were comparable by gender, age and traditional cardiovascular risk factors.

Results
The average waist circumference in kidney transplant recipients with adverse cardiovascular events was 98±14 cm, which was higher than in kidney transplant recipients without adverse cardiovascular events – 94±13 cm, p&lt;0.05.
The triglyceride level in the group of kidney transplant recipients with adverse cardiovascular events was 1.70 (1.30–2.50) mmol/L, which was higher than in kidney transplant recipients without cardiovascular complications – 1.45 (1.08–1.80) mmol/L, p&lt;0.01. Hypertriglyceridemia was more frequently diagnosed in recipients with adverse cardiovascular events – 44.3% (n=35) versus 27.8% (n=44), p&lt;0.05. In the study groups no statistically significant differences were found in the level of high-density lipoproteins and the incidence of their reduced level depending on the occurrence of adverse cardiovascular events – 1.30 (1.21–1.42) mmol/L and 20.3% (n=16) versus 1.31 (1.21–1.45) mmol/L and 8.4% (n=29).
The blood pressure level and the incidence of arterial hypertension was comparable in the study groups – 77.2% (n=61) and 69.6% (n=110).
Blood glucose levels and the incidence of hyperglycemia did not differ in the study groups, but post-transplant impaired glucose tolerance or post-transplant diabetes mellitus in recipients with adverse cardiovascular events were more common – 20.3% (n=16) versus 9.5% (n=15), p&lt;0.05.
So 41.8% (n=99) of the study patients had metabolic syndrome. The previous metabolic syndrome was more frequent in recipients with adverse cardiovascular events – 58.2% (n=46) versus 33.5% (n=53), p&lt;0.001.

Conclusion
Based on the study it was found that the metabolic syndrome increases the risk of adverse cardiovascular events in kidney transplant recipients. The main components of metabolic syndrome that have prognostic value in kidney transplant recipients were an increase in waist circumference, high blood triglyceride levels and the incidence of hypertriglyceridemia, a high incidence of post-transplant impaired glucose tolerance or post-transplant diabetes mellitus.

Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Belarusian State Medical UniversityMinsk Scientific and Practical Center of Surgery, Transplantology and Hematology