Metabolic risk factors and long‐term graft function after paediatric renal transplantation

The aim of this study was to evaluate metabolic risk factors and their impact on long‐term allograft function in paediatric renal transplant (RTx) patients. We reviewed the medical records of 210 RTx patients who underwent transplantation at a median age of 4.5 years (range 0.7–18.2) and a median follow‐up of 7.0 years (range 1.5–18.0). Data on lipid and glucose metabolism, uric acid levels, weight and blood pressure were collected up to 13 years post‐RTx, and the findings were correlated with the measured glomerular filtration rate (GFR). Beyond the first year, GFR showed gradual deterioration with a mean decline of 2.4 ml/min/1.73 m²/year. Metabolic syndrome, overweight, hypertension and type 2 diabetes were diagnosed in 14–19%, 20–23%, 62–87% and 3–5% of the patients, respectively. These entities showed only mild association with the concomitant or long‐term GFR values. Dyslipidaemia was common and hypertriglyceridaemia associated with a lower GFR at 1.5 and 5 years post‐RTx (P = 0.008 and P = 0.017, respectively). Similarly, hyperuricaemia was frequent and associated significantly with GFR (P < 0.001). Except for hyperuricaemia and hypertriglyceridaemia, metabolic risk factors beyond the first postoperative year associated modestly with the long‐term kidney graft function in paediatric RTx patients.