Abstract

IBARS BOLANOS, Esther; BORROTO DIAZ, Gerardo; GUERRERO DIAZ, Carlos  and  BARCELO ACOSTA, Malicela. Risk factors for development of insulin-resistance syndrome in the renal transplant. Rev cubana med [online]. 2012, vol.51, n.1, pp. 3-14. ISSN 0034-7523.

Introduction: the insulin-resistance syndrome (IRS) is a frequent complication in the renal transplantation due to multiple factors. Objective: to know which alterations linked to renal transplantation and its treatment are risk factors for appearance of insulin-resistance syndrome. Methods: a case-control study was conducted in 81 patients underwent renal transplantation, with a graft survival higher than 1 year and not to be diabetics before implant. Two groups were established, one including patients with this syndrome (n=39) according to the ATP-III criteria and another as control (n=42). To detect the risk factors pre-transplantation the following variables were compared: age or receptor, time in dialysis, glycemia figures, cholesterol and triglycerides, body mass index (BMI), infection for hepatitis C and a family history of diabetes and post-transplantation variables included immunosuppressive treatment, dose of steroids at third month post-transplantation, cyclosporine A levels and presence or not of rejection. The pre-transplantation variables were categorized in a suitable way for univariate and multivariate analysis where they were statistically significant, in the univariate study: the largest time in dialysis, the great age of recipient, the high figures of pre-transplantation glycemia, the positive to Virus C, body mass index higher than 25 and family history of diabetes, this latter factor was the only with statistic representativeness in multivariate analysis. Analyzing the variables linked to immunosuppressive treatment, only we note that patients with this syndrome had statistically mean values of cyclosporine higher than those without this complication. Conclusions: the insulin resistance syndrome is developed from the alterations present before transplantation and at the moment of implant with the addition of other during the implant course, mainly the immunosuppressive treatment.

Keywords : insulin resistance syndrome; renal transplantation; risk factors; immunosuppression.

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