Maria Deolinda F Neves, Erika B Rangel, João R Sá and Sergio A Dib
The aims of this study were to evaluate the relationship between different phases of diabetic nephropathy and the beneficial effect of successful simultaneous pancreas-kidney transplant (SPKT) on the prevalence of cardiovascular risk factors (CVRF). We analyzed 210 type 1 diabetic patients (age>18 years and diabetes duration ≥ 10 years). Patients were divided into five groups: normo, micro, macroalbuminuric, end stage renal disease (ESRD), and SPKT. The following CVRF, besides diabetes, were analyzed: blood pressure, waist circumference, HDL cholesterol and triglycerides. The prevalence of ≥ 2 CVRF increased from normoalbuminuric to end stage renal disease group: 20.7%, 43.4%, 53.6%, 71.4% (p<0.001), respectively. In the SPKT group, this prevalence was 18.5%. Two or more CVRF were positively associated with female gender (OR=2.5; p=0.008) and with diabetes duration over 15 years (OR=2.6; p=0.023). The SPKT was a protective factor (OR=0.3; p=0.047), and ESRD was a risk factor (OR=5.2, p=0.014) for the presence of CVRF. In conclusion, the severity of diabetic nephropathy was associated with a higher prevalence of two or more CVRF in type 1 diabetes mellitus. After SPKT, that prevalence was similar to normoalbuminuric patients.
