Estudio longitudinal del IMC y de la Obesidad como factores de riesgo de rechazo del injerto renal

Autores/as

  • Adelina Martín Salvador Universidad de Granada. Facultad de Ciencias de la Salud. Departamento de Enfermería
  • Inmaculada García García Universidad de Granada. Facultad de Ciencias de la Salud. Departamento de Enfermería
  • María José Aguilar Cordero Universidad de Granada. Facultad de Ciencias de la Salud. Departamento de Enfermería
  • Rafael José Esteban de la Rosa Servicio de Nefrología Unidad de Hemodiálisis. Hospital Universitario Virgen de las Nieves. Granada
  • Juan Bravo Soto Servicio de Nefrología Unidad de Hemodiálisis. Hospital Universitario Virgen de las Nieves. Granada
  • Rafael Fernández Castillo Universidad de Granada. Facultad de Ciencias de la Salud. Departamento de Enfermería

DOI:

https://doi.org/10.19230/jonnpr.2189

Palabras clave:

Trasplante renal, Alteraciones lipídicas, Hiperlipidemia, Hipiertrigliceridemia, Antropometría

Resumen

Objetivo. Evaluar el rechazo, la nefropatía crónica del injerto (NCI) y el retraso en la función del mismo  (RFI) debido a obesidad e IMC elevado.

Material y Método. En este trabajo se han evaluado 500 pacientes de ambos sexos trasplantados  renales seguidos durante 5 años, se les realizaron mediciones postrasplante de parámetros bioquímicas  y mediciones antropométricas. Se recogieron además datos de nefropatía crónica y función retardada  del injerto.

Resultados. A los 5 años postrasplante se produce un aumento del IMC y un aumento de los  componentes del perfil metabólico: triglicéridos, colesterol total e hiperglucemia, así como de la tensión  arterial. Como consecuencia hemos observado también un aumento en la incidencia de nefropatía  crónica y función retardada del injerto.

Conclusión. La obesidad aumenta significativamente la incidencia de complicaciones postrasplante, lo  que finalmente puede llevar a la pérdida injerto. Un adecuado control del IMC en los receptores de trasplante  renal influiría directamente en la supervivencia del injerto renal a largo plazo, lo que reduciría el retraso en  la función del injerto, la aparición de NCI y prolongaría la supervivencia del injerto renal.

 

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Citas

Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/ National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52.

Porrini E, Delgado P, Torres A. Metabolic syndrome, insulin resistance, and chronic allograft dysfunction. Kidney Int Suppl 2010: S42e6.

Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120:1640-5.

deVriesAP,Bakker SJ, van Son WJ, et al. Metabolic syndrome is associated with impaired long-term renal allograft function; not all component criteria contribute equally.AmJ Transplant 2004;4:1675-83.

Porrini E, Delgado P, Bigo C, et al. Impact of metabolic syndrome on graft function and survival after cadaveric renal transplantation. Am J Kidney Dis 2006;48:134-42.

Israni AK, Snyder JJ, Skeans MA, Kasiske BL. Clinical diagnosis of metabolic syndrome: predicting new-onset diabetes, coronary heart disease, and allograft failure late after kidney transplant. Transpl Int 2012;25:748-57.

Palaniappan L, Carnethon M, Fortmann SP. Association between microalbuminuria and the metabolic syndrome: NHANES III. Am J Hypertens 2003;16:952-8.

Ponticelli C, Graziani G. Proteinuria after kidney transplantation. Transpl Int 2012;25:909-17.

Halimi JM, Buchler M, Al-Najjar A, et al. Urinary albumin excretion and the risk of graft loss and death in proteinuric and nonproteinuric renal transplant recipients.AmJ Transplant 2007;7:618-25.

Koh KK, Han SH, Quon MJ. Inflammatory markers and the metabolic syndrome: insights from therapeutic interventions. J Am Coll Cardiol 2005;46:1978-85.

Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14,719 initially healthy American women. Circulation 2003;107:391-7.

Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107:499-511.

Prasad GV, Bandukwala F, Huang M, Zaltzman JS. Microalbuminuria post-renal transplantation: relation to cardiovascular risk factors and C- reactive protein. Clin Transplant 2009;23:313-20.

Fabbian F, Bergami M, Molino C, et al. Risk factors for metabolic syndrome in stable Italian renal transplant patients. Clin Exp Nephrol 2011;15:560-6.

Armstrong KA, Campbell SB, Hawley CM, Nicol DL, Johnson DW, Isbel NM. Obesity is associated with worsening cardiovascular risk factor profiles and proteinuria progression in renal transplant recipients. Am J Transplant 2005;5:2710-8.

Sharif A, Moore R, Baboolal K. Influence of lifestyle modification in renal transplant recipients with postprandial hyperglycemia. Transplantation. 2008;85:353-58.

Favaloro R, Peradejordi M, Bertolotti A, Diez M, Favaloro L, Gomez C, Martinez L, Moscoloni S.. Results of heart transplantation: 16 years' experience in a center in Argentina. Transplant Proc. 2010; 42(1):321-23.

Chang A, Greene TH, Wang X, Kendrick C, Kramer H, Wright J et al. The effects of weight change on glomerular filtration rate. Nephrol Dial Transplant. 2015;30(11):1870-7.

Ji B, Zhang S, Gong L, Wang Z, Ren W, Li Q, et al. The risk factors of mild decline in estimated glomerular filtration rate in a community-based population. Clin Biochem 2013;46(9):750- 4.

Fernández Castillo R, De Alarcon RM, Esteban RJ, Haouari O, Planell E, Perán F, Bravo JA.. Bone mineral density in patients with renal hyperparathyroidism undergoing surgery: relationship with bone parameters. Med Clin (Barc). 2010;135:156-159.

Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/ National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2006;112:2735-52.

Bouvet Y, Bouissou F, Coulais Y, Séronie-Vivien S, Tafani M, Decramer S, et al. GFR is better estimated by considering both serum cystatin C and creatinine levels. Pediatr Nephrol 2006;21(9):1299–306.

Kidney Disease: Improving Global Outcomes. (KDIGO) CKD Work Group. KDIGO clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 2013;1–150.

Barcellos RC, Matos JP, Kang HC, Rosa ML, Lugon JR. Comparison of serum creatinine levels in different color/race categories in a Brazilian population. Cad Saude Publica 2015;31(7):1565–9.

Castillo RF, García Rios MD, Peña Amaro P, García García I. Progression of alterations in lipid metabolism in kidney transplant recipients over 5 years of follow-up. Int J Clin Pract. 2014 Sep;68(9):1141-6.

Pieloch D, Dombrovskiy V, Osband AJ, et al J Ren Nutr. Morbid obesity is not an independent predictor of graft failure or patient mortality after kidney transplantation. 2014 Jan;24(1):50-7

Xu S, Gao B, Xing Y, Ming J, Bao J, Zhang Q, et al. Gender differences in the prevalence and development of metabolic syndrome in Chinese population with abdominal obesity. PLoS One 2013;8(10):e78270.

Jadhav K, John R, Agrawal V, Samant P, Rai S. Prevalence of metabolic syndrome in college students in Navi Mumbai. Int J Med Allied Sci 2014;1(2):76–84.

Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, et al. Chronic kidney disease: global dimension and perspectives. Lancet 2013;382(9888):260–72.

Sarafidis PA, Lasaridis AN. Insulin resistance and endothelin: another pathway for renal injury in patients with the cardiometabolic syndrome? J Cardiometab Syndr 2008;3: 183–7.

Felizardo RJ, da Silva MB, Aguiar CF, Câmara NO. Obesity in kidney disease: a heavyweight opponent. World J Nephrol 2014;3(3):50–63.

Hall ME, do Carmo JM, da Silva AA, Juncos LA, Wang Z, Hall JE. Obesity, hypertension, and chronic kidney disease. Int J Nephrol Renovasc Dis 2014;7:75–88.

Jadhakhan F, Marshall T, Gill P. A systematic review investigating the cumulative incidence of chronic kidney disease in young adults with impaired glucose tolerance. Syst Rev 2015;4:69.

Publicado

2018-01-18