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

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.