High prevalence of the metabolic syndrome and associated left ventricular hypertrophy in pediatric renal transplant recipients

Wilson AC, Greenbaum LA, Barletta GM, Chand D, Lin J-J, Patel HP, Mitsnefes M. High prevalence of the metabolic syndrome and associated left ventricular hypertrophy in pediatric renal transplant recipients.Pediatr Transplantation 2010: 14: 52–60© 2009 John Wiley & Sons A/S. Abstract: The goal of this study was to estimate prevalence of the metabolic syndrome and its association with cardiac abnormalities in children with kidney transplant. A multi-center retrospective review of demographic, clinical, laboratory, and echocardiographic parameters at time of and at one-yr post-transplant was conducted in 234 pediatric recipients between 2000 and 2006. Eighty-eight patients (37.6%) met criteria for metabolic syndrome. Among 55 overweight patients, 40% had metabolic syndrome. Among 51 obese patients, 74.5% had metabolic syndrome. A total of 181 (71.0%) patients had complete data at both time points: prevalence of metabolic syndrome at time of transplant was 18.8%, compared with 37.0% at one-yr post-transplant (p < 0.0001). Among 147 patients without metabolic syndrome at time of transplant, 41 (27.9%) had developed metabolic syndrome by one-yr post-transplant. A total of patients from four centers had routine echocardiogram at one-yr post-transplant. LVH was significantly more common in those with metabolic syndrome (55%) than in those without (32%) (OR 2.6, 95% CI 1.2–5.9). In conclusion: metabolic syndrome is common at time of pediatric kidney transplant, and prevalence rises sharply at one-yr post-transplant. The presence of metabolic syndrome is strongly associated with LVH in these patients.