Implementation of guidelines for metabolic syndrome control in kidney transplant recipients: Results at a single center

Inbal Houri, Keren Tzukert, Irit Mor Yosef Levi, Michal Aharon, Aharon Bloch, Olga Gotsman, Rebecca Backenroth, Ronen Levi, Iddo Ben Dov, Dvora Rubinger, Michal Dranitzki Elhalel*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Cardiovascular disease is a leading cause of death among kidney transplant recipients. Metabolic syndrome increases the risk for cardiovascular events and decreases graft survival. Lately, guidelines for management of the metabolic syndrome, primarily hypertension, diabetes mellitus (DM) and hypercholesterolemia have dramatically changed in an attempt to decrease cardiovascular risks among kidney transplant recipients. In the present study we examined whether these guideline changes had impact on our management of post-transplantation patients and the subsequent treatment outcomes for these diseases. Methods: Data were obtained from kidney transplant clinic files from two follow-up (FU) periods - between 1994-1997 and between 2008-2011. Demographic data, monitoring and screening frequency for cardiovascular risk factors, immunosuppression regimen, treatment for hypertension, diabetes and hyperlipidemia, treatment outcomes and graft function changes were compared between the two follow-up periods. Results: There was a significant increase in the percentage of patients undergoing transplantation due to renal failure secondary to diabetes and/or hypertension. Patient monitoring and screening during the second FU period were less frequent, but more targeted, reflecting changes in clinic routines. Blood pressure was better controlled in the second FU period (p < 0.01), as was hypercholesterolemia (p < 0.001). High fasting glucose levels were more prevalent among patients in the second group (p < 0.005), although more patients received treatment for DM (p < 0.001). Significantly, fewer patients experienced deterioration of kidney functions during the second FU period (p < 0.001). Conclusions: We found that guideline changes had impact on clinical practice, which translated to better control of the metabolic syndrome. DM control is challenging. Overall, stability of kidney function improved.

Original languageAmerican English
Article number90
JournalDiabetology and Metabolic Syndrome
Volume7
Issue number1
DOIs
StatePublished - 16 Oct 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 Houri et al.

Keywords

  • Kidney transplantation
  • Metabolic syndrome
  • Treatment practice

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