One year follow-up of the cardio-metabolic profile evolution in renal transplant patients treated with alemtuzumab, cyclosporine, and steroids in a reference hospital in Colombia

Abstract

Introduction: Cardiovascular events occur 50 times more often in kidney transplant patients than in the general population and are the leading cause of death. The aim of the study was to evaluate the behavior of cardio-metabolic profile and determine the incidence of major cardiovascular events in the first year after transplantation. Methods: This prospective study evaluated the behavior of cardio-metabolic profile in adult patients that were transplanted during 2011. Results: The median age was 44.3 ± 12.05 years, 68.7% were men and 95.5%, hypertensive. Alemtuzumab-cyclosporine and steroids were used in 89.6%, delaying the introduction of the antimetabolite. In the first year after transplantation there were three cases of diabetes mellitus, three major cardiovascular events, and 12 cases of acute rejection. Albumin, hemoglobin, weight, body mass index (BMI), calcium and HbA1C increased (p<0.05), whereas paratohormone, phosphorus, creatinine and uric acid decreased (p<0.05). Glomerular filtration rate (GFR) was higher in patients without rejection (p=0.001). Conclusion: This immunosuppressive protocol with alemtuzumab, cyclosporine and steroids, and the delayed introduction of the antimetabolite improved bone mineral metabolism, uric acid, albumin and hemoglobin, but there were negative effects on HbA1c, weight and BMI. There was a low incidence of new onset diabetes mellitus and major cardiovascular events.