Prevalence of metabolic syndrome and its associated factors in renal transplant recipients.

Introduction: The population of patients undergoing renal transplantation is considered at highrisk for developing obesity and changes in lipid and glucose metabolism, due to the use of immunosuppressive drugs and increased food freedom in the post-transplant period.

Objective: This study was designed to assess the prevalence of metabolic syndrome in renal transplant recipients and to identify factors associated with its occurrence.

Methods: A cross-sectional study was performed in renal transplant patients, with more than six months of follow-up. The metabolic syndrome was diagnosed according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III.

Results: Among the 87 patients enrolled, 39 (44.8%) presented the phenotype of metabolic syndrome. The mean age of the patients was 43.5 ± 12.1 years-old, with a predominance of male (69.0%) and white (66.7%). The mean and median times of post transplant follow-up were 64.2 ± 49.4 and 56 months, respectively. All the 12 patients who developed post-transplant diabetes mellitus also met the criteria for metabolic syndrome, which compromised the inclusion of this variable in the logistic regression. In the univariate analysis, patients with metabolic syndrome had higher mean age (p = 0.008), higher median blood level of cyclosporine (p = 0.021), higher prevalence of history of coronary disease (p = 0.023), and they were more frequent users of beta (p = 0.011) and calcium- channel blockers (p = 0.039). In the multivariate analysis, age (HR = 1.06; 95% CI=1.01-1.11, p=0.006) and use of beta-blockers (HR = 4.02; 95% CI = 1.41 - 11.4, p = 0.009) were associated with increased risk of metabolic syndrome.

Conclusion: Metabolic syndrome was highly prevalent in the population of renal trans- plant recipients studied, and it was associated with older age, use of beta-blockers, and post-transplant diabetes mellitus.