High Prevalence of the Metabolic Syndrome and Associated Left Ventricular Hypertrophy in Pediatric Renal Transplant Recipients

Background: Individual cardiovascular (CV) risks are common after pediatric renal transplant. The prevalence of metabolic syndrome and its association with CV abnormalities are unknown in this population.

Methods and Results: Multi-center retrospective review was performed at time of and at 1-year post transplant for 256 consecutive patients. 37.6% met diagnostic criteria for metabolic syndrome at 1-year post transplant. Among 181 patients with complete data at both time points, 18.8% met diagnostic criteria at time of transplant, versus 37.0% at 1-year (p<0.0001). Among patients with metabolic syndrome, mean LV mass index (LVMI) was 48.3g/m^2.7 versus 40.0g/m^2.7 (p=0.0008) in those without. Left ventricular hypertrophy (LVH) was more common in those with metabolic syndrome (55% versus 32%) (OR 2.6, 95% CI 1.2-5.9).

Conclusions: Metabolic syndrome is common at time of pediatric renal transplant, and prevalence rises sharply at 1-year post transplant. Metabolic syndrome is associated with increased LVMI and LVH in this population.