Seguimiento por un año de la evolución del perfil cardiometabólico en pacientes trasplantados renales tratados con alemtuzumab, ciclosporina y esteroides en un hospital de referencia en Colombia

  • John Fredy Nieto-Ríos Hospital Pablo Tobón Uribe.
  • Narly Viviana Gómez-Rueda Universidad Pontificia Bolivariana
  • Lina María Serna-Higuita Hospital Pablo Tobón Uribe.
  • Catalina Ocampo-Kohn Hospital Pablo Tobón Uribe.
  • Arbey Aristizabal-Alzate Hospital Pablo Tobón Uribe.
  • Harry Abadía-Guzmán Hospital Pablo Tobón Uribe.
  • Carlos Enrique Yepes-Delgado Hospital Pablo Tobón Uribe. Universidad de Antioquia.
  • Gustavo Adolfo Zuluaga-Valencia Hospital Pablo Tobón Uribe.
Palabras clave: Enfermedad Cardiovascular, Factores de Riesgo Cardiovascular, Trasplante Renal

Resumen

Introducción: en los pacientes trasplantados renales los eventos cardiovasculares ocurren 50 veces más que en la población general y son la principal causa de muerte. El objetivo del estudio fue evaluar el comportamiento del perfil cardio-metabólico y determinar la frecuencia de eventos cardiovasculares mayores en el primer año del trasplante.

Métodos: estudio prospectivo en el que se evaluó el perfil cardio-metabólico en 67 pacientes adultos trasplantados durante el 2011.

Resultados: la edad promedio fue 44,3±12,05 años, 68,7 % eran hombres y 95,5 %, hipertensos. En el 89,6 % se empleó alemtuzumab-esteroides y ciclosporina e introducción tardía del antimetabolito. Se presentaron 3 diabetes mellitus postrasplante, 3 eventos cardiovasculares mayores y 12 rechazos agudos. Al año, la albúmina, la hemoglobina, el índice de masa corporal, el calcio y la HbA1C aumentaron con respecto al valor previo al trasplante (p<0,05), mientras que la paratohormona, el fósforo, la creatinina y el ácido úrico disminuyeron (p<0,05). La tasa de filtración glomerular (TFG) al año fue mayor en los pacientes sin rechazo (p 0,001).

Conclusión: la terapia inmunosupresora con alemtuzumab–ciclosporina- steroides mostró que al año del trasplante hubo mejoría significativa del metabolismo mineral óseo, el ácido úrico, la albúmina y la hemoglobina, pero empeoraron significativamente la HbA1c, el peso y el IMC, con una baja frecuencia de casos nuevos de diabetes mellitus y eventos cardiovasculares mayores.

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Biografía del autor/a

John Fredy Nieto-Ríos, Hospital Pablo Tobón Uribe.

Nefrologo. Hospital Pablo Tobón Uribe, Medellín, Colombia.

Narly Viviana Gómez-Rueda, Universidad Pontificia Bolivariana

Medicina Interna. Universidad Pontificia Bolivariana, Medellín, Colombia.

Lina María Serna-Higuita, Hospital Pablo Tobón Uribe.

Nefrologa Pediatra. Hospital Pablo Tobón Uribe, Medellín, Colombia. Docente departamento de Pediatria y Puericultura, Universidad de Antioquia, Medellín, Colombia.

Catalina Ocampo-Kohn, Hospital Pablo Tobón Uribe.

Nefrologo. Hospital Pablo Tobón Uribe, Medellín, Colombia.

Arbey Aristizabal-Alzate, Hospital Pablo Tobón Uribe.

Nefrologo. Hospital Pablo Tobón Uribe, Medellín, Colombia.

Harry Abadía-Guzmán, Hospital Pablo Tobón Uribe.

Cirujano de Trasplante. Hospital Pablo Tobón Uribe, Medellín, Colombia.

Carlos Enrique Yepes-Delgado, Hospital Pablo Tobón Uribe. Universidad de Antioquia.

Epidemiologo Clinico. Hospital Pablo Tobón Uribe, Medellín, Colombia. Profesor titular. Universidad de Antioquia, Medellín, Colombia.

Gustavo Adolfo Zuluaga-Valencia, Hospital Pablo Tobón Uribe.

Nefrologo. Hospital Pablo Tobón Uribe, Medellín, Colombia.

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Publicado
2015-09-22
Cómo citar
1.
Nieto-Ríos JF, Gómez-Rueda NV, Serna-Higuita LM, Ocampo-Kohn C, Aristizabal-Alzate A, Abadía-Guzmán H, Yepes-Delgado CE, Zuluaga-Valencia GA. Seguimiento por un año de la evolución del perfil cardiometabólico en pacientes trasplantados renales tratados con alemtuzumab, ciclosporina y esteroides en un hospital de referencia en Colombia. Iatreia [Internet]. 22 de septiembre de 2015 [citado 22 de septiembre de 2021];28(4):388-99. Disponible en: https://revistas.udea.edu.co/index.php/iatreia/article/view/19976
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