Increased cardiovascular risk profile and mortality in kidney allograft recipients with post-transplant diabetes mellitus in Spain

  1. José Manuel González-Posada1,
  2. Domingo Hernández1,
  3. Beatriz Bayés Genís2,
  4. Lourdes Perez Tamajón1,
  5. Javier García Pérez3,
  6. Benito Maceira1,
  7. Manuel Rivero Sánchez4,
  8. Daniel Serón5,
  9. for the Spanish Chronic Allograft Nephropathy Study Group†

Article first published online: 26 JUL 2006

DOI: 10.1111/j.1399-0012.2006.00532.x

Issue

Clinical Transplantation

Clinical Transplantation

Volume 20, Issue 5, pages 650–658, September/October 2006

Additional Information

How to Cite

González-Posada, J. M., Hernández, D., Genís, B. B., Tamajón, L. P., Pérez, J. G., Maceira, B., Sánchez, M. R., Serón, D. and for the Spanish Chronic Allograft Nephropathy Study Group (2006), Increased cardiovascular risk profile and mortality in kidney allograft recipients with post-transplant diabetes mellitus in Spain. Clinical Transplantation, 20: 650–658. doi: 10.1111/j.1399-0012.2006.00532.x

Author Information

  1. 1

    Nephrology Service, Hospital Universitario de Canarias, La Laguna, Spain

  2. 2

    Nephrology Service, Hospital Germans Trias i Pujol, Badalona, Spain

  3. 3

    Nephrology Service, Hospital Virgen de la Candelaria, Santa Cruz de Tenerife, Spain

  4. 4

    Nephrology Service, Hospital Puerta del Mar, Cadiz, Spainx

  5. 5

    Nephrology Service, Hospital Universitario de Bellvitge, Barcelona, Spain

  1. †

    Participants of the Spanish Chronic Allograft Nephropathy Study Group (see ‡ to this article).

*Dr JM González-Posada, Nephrology Service, Hospital Universitario de Canarias, Ofra s/n. La Laguna, 38320 Sta Cruz de Tenerife, Spain. Tel.: 34 922 678 544; fax: 34 922 644 313; e-mail: jmgposada@hotmail.com

Publication History

  1. Issue published online: 26 JUL 2006
  2. Article first published online: 26 JUL 2006
  3. Accepted for publication 5 May 2006

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Keywords:

  • cardiovascular risk;
  • kidney transplantation;
  • patient survival;
  • post-transplant diabetes mellitus

Abstract:  Background:  Post-transplant diabetes mellitus (PTDM) is associated with poorer outcomes in kidney transplantation (KT) but little information exists about the evolution of traditional cardiovascular risk (CVR) factors under this disorder.

Methods:  We retrospectively analysed CVR factors at 3, 12 and 24 months of follow-up and mortality at three yr in 3365 KT performed in Spain during the years 1990, 1994 and 1998 with a functioning graft after the first year. Three groups were considered: (i) (PTDM, n, 251), (ii) diabetes mellitus as primary disease (DM, n = 156) and (iii) the remaining patients (controls, n = 2958).

Results:  Recipient age, weight and body mass index (BMI) were higher in PTDM than in the other groups (p < 0.0001), with a lower increase of body weight during follow-up (p < 0.003). PTDM patients showed higher total-cholesterol levels than controls at one (p < 0.01) and two yr (p < 0.0009), and higher triglyceride levels than the other groups during follow-up (p < 0.002). Compared with Controls, PTDM patients had significantly higher systolic blood pressure at one (p < 0.001) and two yr (p < 0.005). Diastolic blood pressure was higher in PTDM and controls (p < 0.001), while pulse pressure was higher in PTDM and DM patients (p < 0.0001) during follow-up. Using Cox proportional hazards analysis, PTDM correlated with total mortality (RR = 1.55; range 1.05–2.3; p < 0.02) but not with cardiovascular mortality.

Conclusions:  In Spanish KT recipients with graft function after one yr, PTDM is associated with a worse traditional CVR profile and a higher overall mortality. Although short-term cardiovascular mortality remains similar, better control of CVR factors is mandatory to prevent long-term cardiovascular mortality inherent to this population.

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