Metabolic syndrome identified as risk factor for kidney-pancreas transplant patients

January 20, 2006

A three-year multi-center study of kidney-pancreas transplant recipients has identified a new risk factor for impaired kidney function, which may help physicians refine their treatment strategies.

Researchers from Wake Forest University Baptist Medical Center and colleagues reported their findings today at the 6th Annual American Society of Transplant Surgeons State of the Art Winter Symposium in Scottsdale, Ariz.

The researchers found that metabolic syndrome, a cluster of symptoms that increase the risk of heart disease, is also a risk factor for deterioration of kidney function in simultaneous kidney-pancreas transplant recipients. The risk is especially high when the pancreas transplant fails. The study involved 298 patients at 25 transplant centers.

"The findings suggest that we need to do whatever we can to keep the transplanted pancreas functioning because it may protect against development of long-term kidney transplant dysfunction," said Jeffrey Rogers, M.D., a Wake Forest transplant surgeon. "The findings also underscore the importance of controlling weight, blood pressure, blood sugar and cholesterol - the variables that define metabolic syndrome."

In kidney and pancreas transplantation, advances in immunosuppressive drug therapy have significantly reduced the risk of acute rejection. Transplant surgeons are now increasingly focused on developing strategies to prevent or slow a gradual deterioration in kidney function that can lead to the need for a second transplant.

Previous research had shown that metabolic syndrome is a risk factor for chronic deterioration of kidney function in kidney transplant recipients. However, the effect of metabolic syndrome on the outcome of simultaneous kidney-pancreas transplantation and the significance of having a functioning pancreas transplant in these patients has not been previously described.

About 700 kidney-pancreas transplants are performed each year in the United States. The procedure is performed in patients who have either type 1 or type 2 diabetes and kidney failure. The pancreas produces insulin, a hormone that helps regulate levels of blood sugar. People with diabetes do not produce enough insulin or cannot use insulin effectively. The primary function of the kidneys is to filter waste products and extra water from the body by producing urine.

Metabolic syndrome is diagnosed when someone has at least three of these following: body mass index greater than 30 or waist size larger than 40 inches for men or 35 inches for women, high levels of triglycerides, low levels of "good" cholesterol, high blood pressure or high levels of blood sugar.

The study followed 298 patients for three years after simultaneous kidney-pancreas transplantation. The researchers found that the prevalence of metabolic syndrome decreased from 59 percent prior to transplant to 19 percent one year after transplant. This would be expected because the transplant would eliminate diabetes - one of the components of metabolic syndrome.

Patients who had metabolic syndrome one year after transplant were 10 times more likely to have reduced kidney function three years after transplant than patients who did not have metabolic syndrome. The researchers analyzed how function of the transplanted pancreas affected the relationship between metabolic syndrome and kidney function and found that patients with metabolic syndrome who developed early pancreas transplant failure had the highest risk of developing long-term kidney dysfunction.

Rogers said that further study was needed to better understand the role a functioning pancreas transplant plays in preserving kidney transplant function in patients with metabolic syndrome so that long-term survival of both organs can continue to be improved.
-end-
Co-researchers were Robert Stratta, M.D., from Wake Forest, Agnes Lo, Pharm.D., from the University of Tennessee - Memphis, and Rita R. Alloway, Pharm.D., from the University of Cincinnati.

Media Contacts: Karen Richardson, krchrdsn@wfubmc.edu; Shannon Koontz, shkoontz@wfubmc.edu, at 336-716-4587.

Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university's School of Medicine. The system comprises 1,187 acute care, psychiatric, rehabilitation and long-term care beds and is consistently ranked as one of "America's Best Hospitals" by U.S. News & World Report.

Wake Forest Baptist Medical Center

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.