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Metabolic syndrome (MS) is characterized by a combination of cardiovascular (CV) risk factors (hypertension, dyslipidemia, obesity, and alterations in glucose homeostasis). Insulin resistance is suggested to be the common pathogenic background. This syndrome is also a risk factor for diabetes and chronic kidney disease. In renal transplant recipients, MS has been shown to be an independent risk factor for chronic allograft dysfunction, graft failure, new-onset diabetes, and CV disease. We performed a cross-sectional study on 106 stable renal transplant recipients to detect MS between January 2013 and August 2013. This syndrome was diagnosed according to the National Cholesterol Education Program-Adult Treatment Panel III criteria. Patients with history of diabetes mellitus were excluded from the study. In this group of patients, 56 (52.8%) had MS. There were 32 males (57.1%) and 24 females (42.9%). The mean age of the MS group was significantly higher than the non-MS group. The mean serum creatinine was higher in the MS group than the non-MS group, but there was no significant difference between them (P >0.05). The calculated glomerular filtration rate was also similar in the two groups (P >0.05). The patients with MS had higher body weight (64.61 ± 14.17 kg vs. 58.76 ± 11.70 kg, P <0.05) and also higher body mass index (BMI) (P <0.05). The prevalence of BMI >25 kg/m2 in the MS group was 75% versus 25% in the non-MS group (P <0.05). Since MS is an important and common risk factor in renal transplant recipients, we have to try to prevent it by educating the patients to control it by modifying their lifestyle. Efforts toward promoting healthy diets, physical activity, and blood pressure control must be undertaken.

Background: Tuberculosis (TB) is an important infection encountered posttransplantation, especially among patients in developing countries, where there are high incidences of morbidity and mortality., Materials and Methods: One hundred and twenty subjects (1%) from 15 major kidney transplantation centers in Iran from 1984 to 2003 were compared with 440 controls who were matched for operative time, treatment center, and surgical team., Results: Mean ages of research subjects and controls were 38.6 and 36.6 years (P = .04), respectively. The mean duration of pretransplantation hemodialysis was 29 months (range, 2 to 192 months) in research subjects and 20 months (range, 1 to 180 months) in controls (P = .003). Positive past history of tuberculosis was detected in 4 (3.3%) research subjects and in 7 (1.5%) controls (P = .2). Fifty-two research subjects (43.3%) and 241 controls (54.8%) had pretransplantation purified protein derivative of tuberculin less than 5 mm (P = .02). Mean dosages of initial and maintenance immunosuppressive drugs in research subjects and in controls were not significantly different. Sixty research subjects (50%) and 152 controls (34.5%) had rejection prior to diagnosis of TB (P = .03)., Conclusion: To our knowledge, this is the first study that demonstrates an increased risk of posttransplant TB by prolonged duration of pretransplant hemodialysis and number of posttransplant rejection episodes. Further study is needed to clarify these findings specifically with respect to various immunosuppressive regimens.

Background: Metabolic syndrome (MS) is a collection of known cardiovascular risk factors including hypertension, dyslipidemia, truncal obesity, and impaired glucose tolerance. Vitamin D is one of known lipophilic hormones that have major effects on the homeostasis of calcium and phosphorus. There are reports in general population showing low serum 25-OH D3 levels may be associated with higher prevalence of MS. Objective: As MS reduces graft survival after transplantation, this study aims to find relationship between vitamin D deficiency and metabolic syndrome on kidney transplant patients. Methods: We performed a cross-sectional study from October 2014 to Mach 2015, on 86 stable renal transplant recipients to detect relation between serum vitamin D level and MS. This syndrome was diagnosed according to the Asian National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria. Patients with pervious history of diabetes mellitus, malabsorption syndrome, chronic diarrhea, and ileostomy, and those with recent use of oral or injection of vitamin D products, anti-convulsants, and alcohol were excluded from the study. Results: There were 43 patients in each group with and without MS. 30 of them (70%) had three diagnostic criteria of MS; 13 (30%) had four criteria. Totally, they were 48 (56%) males and 38 (44%) females. The mean age of those with MS was significantly higher than those without MS. There was no significant difference between mean serum creatinine and GFR between the two groups. Those with MS had higher weight and body mass index (BMI) (p<0.05) compared to those without MS. The prevalence of BMI >25 kg/m2 in MS group was 54% vs. 33% in non-MS group (p<0.05). In MS group 64.3% of patients had vitamin D deficiency, 21% had vitamin D insufficiency and 14% had sufficient level of vitamin D. The rates in non-MS group were 49%, 30%, and 21%, respectively. Although the prevalence were higher in MS group, the difference was not significant. Conclusion: It seems that MS are commonly associated with vitamin D deficiency in kidney transplant recipients and correction of this vitamin deficiency may prevent MS and its side effects and thus increase graft survival. [ABSTRACT FROM AUTHOR]