Improved Cardiovascular Risk Profile of Patients With Type 1 Diabetes Mellitus and Renal Failure After Simultaneous Pancreas–Kidney Transplantation

Pérez-Tamajón, Lourdes; Miranda, Domingo Marrero; Figueroa, A. Caballero; Marrero, Domingo Hernández; Cerdeña, Ignacio Laynez; Gutiérrez, Alberto Bravo; Fernández, María Dolores Meneses; Hernández, Alberto Miguel Brito; Herrera, Luis Morcillo; Delgado, José Manuel González-Posada

doi:10.1016/j.transproceed.2005.09.156

Cited by 14 publications

(3 citation statements)

References 6 publications

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“…We choose to evaluate patients submitted to SPKT a minimum period of 6 months after the transplant, because from this period onwards, the immunosuppressive doses, mainly from corticosteroids and calcineurin inhibitors, were lower and had less impact on metabolic parameters and kidney function. That approach was in line with the findings that kidney function reestablishment and normalization of blood glucose levels achieved after SPKT, as reported by other studies, resulted in a reduction of cardiovascular risk factors [26].…”

Section: Discussionsupporting

confidence: 91%

Prevalence of Cardiovascular Risk Factors on Different Phases of Diabetic Nephropathy in Comparison to Type 1 Diabetes Recipients who had Undergone Simultaneous Pancreas Kidney Transplant

Neves¹

2013

http://www.omicsonline.org/jdmhome.php

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Section: Discussionsupporting

confidence: 91%

Prevalence of Cardiovascular Risk Factors on Different Phases of Diabetic Nephropathy in Comparison to Type 1 Diabetes Recipients who had Undergone Simultaneous Pancreas Kidney Transplant

Neves¹

2013

http://www.omicsonline.org/jdmhome.php

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“…Prior studies in patients with type 1 diabetes and renal failure have shown that SPKT improves several CVD risk factors including glucose, blood pressure, and lipid levels when compared with kidney transplant alone (18). In our study, MACE occurred in 7.8% of patients over 5 years.…”

Section: Conclusion Prior Studies Of Event Rates In Relation To the mentioning

confidence: 44%

Major Adverse Cardiovascular Events Following Simultaneous Pancreas and Kidney Transplantation in the United Kingdom

et al. 2019

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People with type 1 diabetes and kidney failure have an increased risk for major adverse cardiovascular events (MACE). Simultaneous pancreas and kidney transplantation (SPKT) improves survival, but the long-term risk for MACE is uncertain. RESEARCH DESIGN AND METHODS We assessed the frequency and risk factors for MACE (defined as fatal cardiovascular disease and nonfatal myocardial infarction or stroke) and related nonfatal MACE to allograft failure in SPKT recipients with type 1 diabetes who underwent transplantation between 2001 and 2015 in the U.K. In a subgroup, we related a pretransplant cardiovascular risk score to MACE. RESULTS During 5 years of follow-up, 133 of 1,699 SPKT recipients (7.8%) experienced a MACE. In covariate-adjusted models, age (hazard ratio 1.04 per year [95% CI 1.01-1.07]), prior myocardial infarction (2.6 [1.3-5.0]), stroke (2.3 [1.2-4.7]), amputation (2.0 [1.02-3.7]), donor history of hypertension (1.8 [1.05-3.2]), and waiting time (1.02 per month [1.0-1.04]) were significant predictors. Nonfatal MACE predicted subsequent allograft failure (renal 1.6 [1.06-2.6]; pancreas 1.7 [1.09-2.6]). In the subgroup, the pretransplant cardiovascular risk score predicted MACE (1.04 per 1% increment [1.02-1.06]). CONCLUSIONS We report a high rate of MACE in SPKT recipients. There are a number of variables that predict MACE, while nonfatal MACE increase the risk of subsequent allograft failure. It may be beneficial that organs from hypertensive donors are matched to recipients with lower cardiovascular risk. Pretransplant cardiovascular risk scoring may help to identify patients who would benefit from risk factor optimization or alternative transplant therapies and warrants validation nationally. Type 1 diabetes affects ;400,000 people in the U.K. (1). Type 1 diabetes significantly reduces life expectancy predominantly because of cardiovascular disease (CVD) complications (2,3). The addition of chronic kidney disease further increases CVD risk (4). We have shown that simultaneous pancreas and kidney transplantation (SPKT)

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“…The most prominent data of this study is the finding of lower LDL‐c levels after PKT in a group of statin‐naïve patients. Mean LDL‐c levels reduced by almost 30%, when compared with basal levels from the same group, and such an important improvement had not been described in previous studies (3, 17–22). Moreover, it could be observed an improvement in other components of the metabolic syndrome, such as the TG levels and the frequency of hypertension, although it was observed an increase of body mass index as a result of a probable better metabolic condition following successful PKT procedure.…”

Section: Discussionmentioning

confidence: 50%

The impact of functioning pancreas–kidney transplantation and pancreas alone transplantation on the lipid metabolism of statin‐naïve diabetic patients

Lauria

Figueiro

Machado

et al. 2009

Clinical Transplantation

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Improved Cardiovascular Risk Profile of Patients With Type 1 Diabetes Mellitus and Renal Failure After Simultaneous Pancreas–Kidney Transplantation

Cited by 14 publications

References 6 publications

Prevalence of Cardiovascular Risk Factors on Different Phases of Diabetic Nephropathy in Comparison to Type 1 Diabetes Recipients who had Undergone Simultaneous Pancreas Kidney Transplant

Prevalence of Cardiovascular Risk Factors on Different Phases of Diabetic Nephropathy in Comparison to Type 1 Diabetes Recipients who had Undergone Simultaneous Pancreas Kidney Transplant

Major Adverse Cardiovascular Events Following Simultaneous Pancreas and Kidney Transplantation in the United Kingdom

The impact of functioning pancreas–kidney transplantation and pancreas alone transplantation on the lipid metabolism of statin‐naïve diabetic patients

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