Source:http://linkedlifedata.com/resource/pubmed/id/12817077
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:dateCreated |
2003-6-20
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| pubmed:abstractText |
Obesity and hyperhomocysteinaemia are found very frequently after kidney transplantation (Tx). They may independently represent risk factors for development of atherosclerosis and chronic allograft nephropathy. In a prospective metabolic study, we monitored, over a period of 24 months, a total of 118 obese transplant patients [body mass index (BMI) > or =30 kg/m(2)] with hyperhomocysteinaemia. We compared the findings of a new therapeutic regimen at 1 year (start of the study) and 2 years after renal transplantation. Based on a Subjective Global Assessment Scoring Sheet, we started at the end of the first year with an individualized hypoenergic-hypolipidaemic diet (IHHD). Subsequently, after corticoid withdrawal, IHHD was supplemented regularly with orlistat at a dose of up to 3 x 120 mg/day, statins (pravastatin 10-40 mg), folic acid 5 mg/day and vitamin B6 50 mg/day, and followed-up for up to 2 years. All patients were on a regimen of cyclosporin A and mycophenolate mofetil. During the study period, there was a significant decrease in BMI (P < 0.025) and total homocysteine level (P < 0.001). Long-term therapy was associated with a significant decrease in serum leptin (P < 0.001) and lipid metabolism parameters (P < 0.01). The mean values of serum folate and vitamin B6 also increased significantly (P < 0.01); creatinine clearance, mean blood pressure, proteinuria, lipoprotein(a) and apolipoprotein E isoforms did not differ significantly. Based on our results, we assume that obesity and hyperhomocysteinaemia after renal transplantation can be treated effectively by modified immunosuppression (corticosteroid withdrawal), long-term diet (IHHD), folic acid and vitamin B6 supplementation, and drugs suppressing digestion or absorption to reduce atherosclerotic and chronic allograft nephrop-athy processes.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:month |
Jul
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| pubmed:issn |
0931-0509
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:volume |
18 Suppl 5
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
v71-3
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| pubmed:dateRevised |
2006-11-15
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| pubmed:meshHeading |
pubmed-meshheading:12817077-Adult,
pubmed-meshheading:12817077-Aged,
pubmed-meshheading:12817077-Cohort Studies,
pubmed-meshheading:12817077-Combined Modality Therapy,
pubmed-meshheading:12817077-Diet Therapy,
pubmed-meshheading:12817077-Drug Therapy, Combination,
pubmed-meshheading:12817077-Female,
pubmed-meshheading:12817077-Folic Acid,
pubmed-meshheading:12817077-Follow-Up Studies,
pubmed-meshheading:12817077-Graft Rejection,
pubmed-meshheading:12817077-Graft Survival,
pubmed-meshheading:12817077-Humans,
pubmed-meshheading:12817077-Hyperhomocysteinemia,
pubmed-meshheading:12817077-Immunosuppressive Agents,
pubmed-meshheading:12817077-Kidney Failure, Chronic,
pubmed-meshheading:12817077-Kidney Transplantation,
pubmed-meshheading:12817077-Male,
pubmed-meshheading:12817077-Middle Aged,
pubmed-meshheading:12817077-Obesity,
pubmed-meshheading:12817077-Postoperative Complications,
pubmed-meshheading:12817077-Pravastatin,
pubmed-meshheading:12817077-Probability,
pubmed-meshheading:12817077-Prospective Studies,
pubmed-meshheading:12817077-Risk Assessment,
pubmed-meshheading:12817077-Treatment Outcome,
pubmed-meshheading:12817077-Vitamin B 6
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| pubmed:year |
2003
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| pubmed:articleTitle |
Obesity and hyperhomocysteinaemia after kidney transplantation.
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| pubmed:affiliation |
Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Chair of Nephrology, Institute for Postgraduate Medical Education, Prague, Czech Republic. vladimir.teplan@medicon.cz
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| pubmed:publicationType |
Journal Article,
Comparative Study,
Research Support, Non-U.S. Gov't
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