Obesity, metabolic syndrome and diabetes mellitus after renal transplantation: prevention and treatment.

摘要: The prevalence of the metabolic syndrome in dialysis patients is high and further increases after transplantation due to weight gain detrimental effects immunosuppressive drugs. Corticosteroids cause insulin resistance, hyperlipidemia, abnormal glucose metabolism arterial hypertension. calcineurin inhibitor tacrolimus diabetogenic by inhibiting secretion, whereas cyclosporine causes hypertension cholesterol levels. Mtor antagonists are responsible for hyperlipidemia mechanisms that also implicate resistance. transplant recipients has numerous such as increasing risk new onset diabetes, cardiovascular disease events patient death. In addition, it been linked with accelerated loss graft function, proteinuria ultimately loss. Prevention management based on physical activity, promotion control factors. Bariatric surgery before or renal body mass index >35 kg/m(2) an option but its long term survival have not investigated. Steroid withdrawal replacement facilitate mtor can improve hyperlipidemia. costimulation belatacept potent properties without adverse will be important component regimens better profile. Medical treatment factors take potential drug interactions medication accumulation insufficiency into account.