Metabolic syndrome identified as risk factor for kidney-pancreas transplant patients
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.
Karen Richardson | EurekAlert!
The most recent press releases about innovation >>>
Die letzten 5 Focus-News des innovations-reports im Überblick:
New success for Konstanz physicists in studying the quantum vacuum
An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...
HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host
Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales
Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...