Metabolic Syndrome and Cardiovascular Outcomes in Pediatric Kidney Transplant Recipients-A Cross-Sectional Study.

BACKGROUND

The study aimed to determine the prevalence of obesity and metabolic syndrome (MS) and analyze the cardiovascular outcomes in pediatric kidney transplant recipients from a single center in India.

METHODS

Determinants of MS, including weight, height, body mass index (BMI), blood pressure, fasting blood sugar, triglyceride, and high-density lipoprotein (HDL) were collected for children with at least 1 year follow-up post-transplant. Cardiovascular outcomes were hypertension, left ventricular hypertrophy (LVH), and carotid intima medial thickness (cIMT). Muscle strength was evaluated by measuring hand grip strength (HGS). Diagnosis of obesity and MS was done by applying recommendations from the Pediatric Renal Nutrition Task Force.

RESULTS

The median age of the cohort (32 recipients, 71% male) was 14.0 years (IQR 12.0, 15.9). At a median 21.5 months (IQR 17, 37.5) after first kidney transplantation, 9 (28.1%) had MS. Hypertriglyceridemia was present in 17 children (53.1%), low HDL cholesterol in 10 (31.2%), hypertension in 22 (68.8%), and fasting hyperglycemia in 7 (21.9%). The ΔBMI height-age Z-score was significantly higher in the MS group (p = 0.003). There was no difference in eGFR, LVMI, Triglyceride index and HGS between the MS and Non-MS groups. In multivariate regression analysis, the ΔBMI height-age Z-score and Acute rejection were independent predictors of MS and LVH, respectively. MS was not an independent predictor of LVH. All patients had elevated cIMT.

CONCLUSION

MS was found in about a third of the cohort. Graft function and LVH were similar between the groups. Post-transplant weight gain was a key determinant of MS.