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Revista Cubana de Medicina

versión impresa ISSN 0034-7523versión On-line ISSN 1561-302X

Resumen

BORROTO DIAZ, Gerardo et al. Impact of hepatitis C virus on the immediate complications and glycemic metabolic disorders of the renal transplant. Rev cubana med [online]. 2008, vol.47, n.4. ISSN 0034-7523.

Hepatitis C virus infection (HCV) exerts a negative influence on the evolution of the kidney transplant on associating with the complications in the immediate posttransplant and with glycemic disorders. The objective of this research was to know the characteristics of the anti HCV positive patients receiving a renal transplant, the main complications in the immediate posttransplant and the metabolic glycemic disorders accompanying them. The data were obtained from the register of renal transplants (RT) of "Hermanos Ameijeiras" Hospital, including the first renal transplants performed from 1995 on. The patients that received a renal transplant and suffered from HCV stood out on being compared with those who were not infected, since they were a longer time under dialysis (months), 28.76 ± 7.09 vs. 14.24 ± 7.05, p = 0.046; had a greater frequency of acute tubular necrosis, 48.7 vs. 35.05 %, p = 0.032; and showed elevated levels of cyclosporin A on the third month of transplant and frequent nephrotoxicity caused by this drug. The incidence of posttransplant diabetes mellitus was 61.2 % (HCV) vs. 32.1 %, p = 0.00017. 83 patients, 39 anti HCV positive patients (46.9 %) and 44 anti HCV negative patients (53.1 %) were subjected to an oral glucose tolerance test with insulin dosage and calculation of HOMA indexes. 62 % of the anti HCV positive presented hyperglycemia associated with RT, whereas it only happened in 39 % of the negative. They were also more insulin resistant with a mean of HOMA R of 5.66 ± 4.86 vs. 3.65 ± 2.9, p = 0.004, as well as less insulin secretors, HOMA-B% 154.28 ± 116 vs. 239 ± 166.9, p = 0.0032.

Palabras clave : Hepatitis C; renal transplant; immediate complications; insulin resistance; posttransplant diabetes.

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