Risk factors of long-term cardiovascular diseases and cerebrovascular diseases in kidney allograft recipients / 中国医学科学院学报

<p><b>OBJECTIVE</b>To identify the risk factors of cardiovascular diseases and cerebrovascular diseases (CVD) events in kidney allograft recipients.</p><p><b>METHODS</b>We followed up 361 renal transplant recipients who had undergone renal transplantation in our center from January 2000 to December 2003 and evaluated the cumulative incidences and mortalities of CVD complications at baseline and post-transplantation 1, 3, 6, 12, 24, 36, 48, and 60 months. Kaplan-Meier plot was used to assess the incidence and Cox's proportional hazards model to determine the risk factors for cardiovascular complications.</p><p><b>RESULTS</b>The cumulative incidences of CVD were 3.1%, 5.4%, 9.9%, 13.0%, 18.0%, 21.1%, and 24.1%, 1, 6, 12, 36, 48, and 60 months after transplantation, respectively. History of diabetes mellitus (RR 2.19, 95% CI 1.32-3.97, P = 0.009) and CVD (RR 6.34, 95% CI 3.76-14.60, P = 0.002) as well as the post-transplantation hypertension (RR 1.18, 95% CI 1.02-1.34, P = 0.04), diabetes mellitus (RR 2.82, 95% CI 1.33-7.26, P = 0.002), hyperlipidemia (RR 2.04, 95% CI 1.26-5.17, P = 0.008) and abnormal creatinine (> 200 micromol/L, RR 1.81, 95% CI 1.08-3.21, P = 0.03), and proteinuria (> 0.3 g/d , RR 1.56, 95% CI 1.12-3.54, P = 0.05) were independently correlated with the development of cardiovascular events.</p><p><b>CONCLUSION</b>History of diabetes mellitus and CVD, post-transplant hypertension, diabetes mellitus, hyperlipidemia, abnormal creatinine and proteinuria are the independent risk factors of the development of CVD events.</p>

Pathogenesis of post-transplantation diabetes mellitus in 40 renal transplantation recipients / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore pathogenesis of post-transplantation diabetes mellitus (PTDM) in renal transplantation recipients.</p><p><b>METHODS</b>A total of 40 renal transplantation recipients were divided into three groups based on oral glucose tolerance test results: normal glucose tolerance (NGT) group (n = 10), impaired fasting glycaemia + impaired glucose tolerance (IFG + IGT) group (n = 16), and PTDM group (n = 14). Insulin resistance (IR) and beta cell function were assessed by homeostasis model.</p><p><b>RESULTS</b>The differences of the immunosuppressive agents used in these groups were not statistically significant (P > 0.05). Compared with NGT group, insulin area under curve and homeostasis model assessment-insulin resistance index were significantly higher in IGT + IFG group and PTDM group (P < 0.05). Compared with NGT group and IGT + IPG group, insulin secretion index at 30 min and homeostasis model assessment-insulin secretion index were significantly lower in PTDM group (P < 0.05).</p><p><b>CONCLUSION</b>Insulin resistance and beta-cell dysfunction may play a key role in the pathogenesis of PTDM.</p>