Variação da espessura do complexo médio-intimal das artérias carótidas e do índice de massa do ventrículo esquerdo em pacientes com diabetes mellitus tipo 1 e insuficiência renal crônica estágio 5 durante hemodiálise e após transplante pâncreas-rim

• Ano de defesa: 2016
• Autor(a) principal: Dantas, Joao Miguel Malta [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: carotid intima-media thickness; left ventricle mass index; type 1 diabetes mellitus; kidney chronic disease type v; simultaneous kidney-pancreas transplant; atherosclerosis; espessura médio-intimal carótidas; índice de massa do ventrículo esquerdo; diabetes mellitus tipo 1; insuficiência renal crônica estágio 5; transplante simultâneo pâncreas-rim; aterosclerose
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=3913962; https://repositorio.unifesp.br/handle/11600/46411

Objectives: Carotid intima-media thickness (CIMT) and left ventricular mass index (LVMI) are independent predictors of death in general population and in patients with renal failure. Simultaneous pancreas-kidney transplantation (SPKT) is curative treatment in patients with type 1 diabetes mellitus (T1DM) and end stage renal disease (ESRD), with significant improvement in length and quality of life. Study objectives were to evaluate changes on CIMT, LVMI and LVEF, in three different timelines: while on hemodialysis and after SPKT, correlating with serum inflammatory markers. Methods: Patients on waiting list for SPKT were prospectively followed-up with routine clinical and laboratory evaluation at least in three protocol-specified timelines: baseline (admission), 12 to 18 months after baseline (pre-transplant) and 18 to 24 months after the successful SPKT (post-transplant). Results: Thirty patients completed study per protocol. In terms of cardiovascular measurements, patients had a statistically significant worsening on CIMT from baseline to pre-transplant, LVMI and left ventricular ejection fraction (LVEF) had a light difference but non significant. However, after 18-24 months of transplant, they improved all the values analyzed. Variables independently correlated with reduced CIMT post-SPKT were age, body mass index and LDL cholesterol. Conclusions: In this group of patients at high cardiovascular risk, changes on CIMT and LVMI (increase) and LVEF (decrease) observed during HD period were reversed after successful SPKT.