Metabolic syndrome is a group of risk factors that occur together,
increasing your risk of heart disease, stroke, and diabetes. These factors
include hypertension, high blood sugar level, excess body fat around the waist
and abnormal cholesterol levels. However, experiencing one of these conditions
doesn't indicate that one has metabolic syndrome. Any of these conditions
increases your risk of cardiovascular disease, and the risk is even greater if more than one
of these medical conditions appear in combination.
‘Guidelines introduced by 'Kidney Disease - Improving Global Outcomes' had an impact on clinical practice, which transformed to better control of the metabolic syndrome. The guidelines help improve the overall stability of kidney function in transplant recipients reducing cardiovascular risk.’
Cardiovascular disease is a leading cause of death in
kidney transplant recipients. Metabolic syndrome raises the risk for
cardiovascular events and decreases graft survival. Recently, new guidelines
for management of the metabolic syndrome, primarily hypertension, DM, and
hypercholesterolemia - an excess of
cholesterol in the bloodstream - have been introduced in an attempt to decrease
cardiovascular risks among kidney transplant recipients.
Earlier, formal guidelines for special populations such as kidney
transplant recipients were not as common as they have become in the last two
decades. Instead, there were common practices as recommended treatment targets.
'Kidney Disease - Improving Global Outcomes' (KDIGO), developed in 2003, has
suggested guidelines for management of patients with
kidney diseases. The 2009 KDIGO guidelines offer
recommendations for the supervision of kidney transplant recipients, including
screening and treatment goals.
In order to study the effectiveness of these guidelines, the
researchers obtained data from kidney transplant clinic files from two
follow-up periods - between 1994 and 1997 and between 2008 and 2011. They
compared demographic data in these two follow-up periods and the treatments
including monitoring and screening frequency for cardiovascular risk, immune
suppression regimen, treatment for high blood pressure, diabetes and
hyperlipidemia.
Results showed that patient's monitoring and screening during the second
follow-up period were less frequent but more targeted. This reflects changes in
clinic routines.
Blood pressure and
hypercholesterolemia were better controlled in the second follow-up period. In
the second group, high fasting glucose levels were more prevalent, although
more patients received treatment for diabetes mellitus. Most significantly,
fewer patients suffered from deterioration of kidney functions during the
second follow-up period.
In conclusion, majority of the patients meet the treatment goals as
pointed out by KDIGO, even though there are still a group of patients who needs
further efforts to attain better clinical outcomes, especially regarding
diabetes control. The
researchers said that the significant improvement we saw in kidney function
stability over time was most gratifying. Overall, the noted changes in the
management of kidney transplant patients in the last decade, including better
control of cholesterol levels and blood pressure are associated with improved
graft function.
The study was published in the Journal,
Diabetology &
Metabolic Syndrome.
Reference:
Inbal Houri, Keren Tzukert, Irit Mor-Yosef Levi, Michal Aharon, Aharon Bloch, Olga Gotsman, Rebecca Backenroth, Ronen Levi, Iddo Ben Dov, Dvora Rubinger and Michal Dranitzki Elhalel doi:10.1186/s13098-015-0083-7
http://www.dmsjournal.com/content/7/1/90
Source: Medindia
