Open AccessEffects of metabolic syndrome on kidney transplantation outcomes: a systematic review and meta‐analysis
Author(s) -
Pedrollo Elis F.,
Corrêa Camila,
Nicoletto Bruna B.,
Manfro Roberto C.,
Leitão Cristiane B.,
Souza Gabriela C.,
Gonçalves Luiz Felipe S.
Publication year - 2016
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12805
Subject(s) - medicine , meta analysis , relative risk , transplantation , kidney transplantation , cochrane library , renal function , randomized controlled trial , confidence interval , surgery
Summary Metabolic syndrome (MS) has been associated with proteinuria and reduced glomerular filtration rate. Immunosuppressive agents increase the incidence of traditional risk factors for cardiovascular disease (CVD) and have known effects on MS components after kidney transplantation. The purpose of this meta‐analysis was to evaluate the impact of MS on relevant outcomes after kidney transplantation. MEDLINE, EMBASE, and Cochrane Library were searched up to November 7, 2015. Papers that compared patients with and without MS and assessed one of the following outcomes, graft loss, death by cardiovascular disease, and all‐cause mortality, were included. Of 585 studies identified, five studies including 1269 patients were evaluated. MS was identified as a risk factor for graft loss [relative risk, 3.06; 95% confidence interval (CI), 2.17, 4.32; I ² = 0%; P heterogeneity = 0.72] and death by CVD (relative risk, 3.53; 95% CI, 1.27, 9.85; I ² = 0%; P heterogeneity = 0.40). Results on the association between MS and all‐cause mortality were inconclusive (relative risk, 2.61; 95% CI, 0.70, 9.81; I ² = 58%; P heterogeneity = 0.09). Graft loss and death by CVD were associated with the presence of MS after transplantation. Randomized clinical trials should be conducted to define whether interventions on each MS component would result in better outcomes after transplantation.