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Volume: 6 Issue: 4 November 2008 - Supplement - 1



Despite the improvement in patient and allograft survival rates in renal transplant population, multiple comorbidities that develop during the follow-up period is still an important problem. Charlson Comorbidity Index (CCI) is a valid index of determination of comorbidities in many disease conditions. There is little data about the clinical associates of CCI in young transplant patients. We tried to investigate the factors affecting comorbidities in a population of young and diabetes free renal transplant recipients. 107 young and diabetes free renal transplant recipients (71 male, 32 female; mean age 34.417.7) with functioning allograft more than one year were included in our study. Demographic and biochemical parameters, fetuin, osteopontin and 25-hydroxyvitamin D levels, presence of insulin resistance with homeostasis model assessment (HOMA-IR), determination of nutritional status with subjective global assessment (SGA) and CCI of these patients were recorded. According to CCI there were 36 (47%) patients with at least one comorbidity (16 (21.1%) patients with one, 13 (17.1%) with two, 3 (3.9%) patients with three and 3 (3.9%) patients with four comorbidities). Among clinical and laboratory parameters, prior hemodialysis duration, SGA score, uric acid and osteopontin levels and biopsy proven chronic allograft nephropathy was found to be positively correlated whereas albumin and mean arterial pressure was negatively correlated with comorbidities. In multivariant analysis only uric acid (OR= 1.48, p 0.046) and dialysis duration (OR= 1.02, p=0.009) correlated with comorbidities. Meanwhile uric acid levels have been found to be a surrogate marker of metabolic syndrome (positive correlation with age, waist circumference and BMI and negative correlation with HDL) and were influenced with graft function in our patients. In conclusion, Duration of prior dialysis and high uric acid levels were among the strongest factors related with comorbidities in young renal transplant patients. Early planning of transplantation and good metabolic control will help to reduce comorbidity in young transplant patients.

Volume : 6
Issue : 4
Pages : 22

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Nephrology and General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey