P8.025: Impact of Full Correction of Post-transplant Anemia on the Cardiovascular System in Renal Transplant Recipients Receiving Erythropoietin Stimulating Agents: Prospective Randomized Controlled Trial

Abstract

Background: Post Transplantation Diabetes Miletus (PTDM) is a chronic metabolic disease developed in some of our kidney transplant patients. PTDM is a chronic, inflammatory disease with a direct impact on patients' immune system. Angiopoietin and Angiopoietin-like are intrinsic mediators induced by immune cells. Objectives: To determine the relationship between circulating Angiopoietin-1 and 2 (ANG-1, 2) and Angiopoietin-like (ANGPTL 3-8) in kidney transplant patients who develop diabetes (PTDM) vs. patients who do not develop diabetes(CONTROL) after kidney transplantation. Methods: In this cross-sectional study, all patients were enrolled from Dasman Diabetes Institute Diabetes Education Department and outpatient clinics of the Hamad Al Essa Organ Transplant Centre of Kuwait between May 2015 and December 2016. The present study included 155 PTDM and 154 controls, age-and sex-matched. We collected 3 ml of venous blood from each subject. Enzyme-linked immunosorbent assay (ELISA) determined plasma ANG 1,2 and ANGPTL 3-8. We determined the correlation between plasma ANG 1 and 2 and ANGPTL3-8 levels in our PTDM and Control group. Results: In our cohorts, most of the patients (56%) were Kuwaiti. Moreover, the two groups were comparable regarding their original kidney disease, dialysis type, donor type, and the type of both induction and maintenance immunosuppression (P > 0.05). Also, pre-transplant co-morbidities were comparable in both groups, including hypertension, history of exposure to tuberculosis bacilli, ischemic heart disease, bone disease, anemia, and hyperlipidemia (P > 0.05). We found significantly higher plasma ANG-1, ANGPTNL 6, 7, 8 levels in the PTDM group compared to the control group (P < 0.001). However, we found no statistical association between our study groups concerning plasma ANG 2, ANGPTNL 3, 4 (p>0.05). Conclusion: Plasma ANG 1, ANGPTNL6, 7, 8 levels may correlate with disease severity, chronicity in transplant patients who develop diabetes post Kidney transplantation, and serve as a potential biomarker of the disease severity.