CORRELATIONS BETWEEN PARAMETERS OF NUTRITIONAL STATUS AND CARDIOVASCULAR RISK IN HYPERTENSIVE RENAL TRANSPLANT RECIPIENTS

Uvod: Cilj navedenoga istraživanja je bio istražiti povezanost čimbenika kardiovaskularnog rizika s nutritivnim statusom bolesnika s funkcionalnim transplantiranim bubregom i arterijskom hipertenzijom (AH). Materijali i metode: U istraživanje je uključeno 55 bolesnika s funkcionalnim transplantiranim bubregom i AH, medijan dobi bio je 63 godine, 33 muškarca (60%) i 22 (40%) žene. Za svakog ispitanika prikupljeni su podatci o spolu, dobi, tjelesnoj težini i visini, opsegu struka i nadlaktice te su izračunati indeks tjelesne mase (ITM), omjer struka i visine (WHtR) te razina glomerularne filtracije (GF). Također, uvidom u medicinsku dokumentaciju prikupljeni su podatci o duljini liječenja dijalizom prije TX, vremenu protekolom od TX bubrega, vrsti i broju antihipertenzivnih lijekova te su određeni biokemijski parametri. Uređaj „Agedio B900“ korišten je za mjerenje centralnog i perifernog arterijskog tlaka te su njime dobiveni podatci za vrijednosti centralnog sistoličkog (CSKT) i dijastoličkog krvnog tlaka (CDKT), perifernog sistoličkog (PSKT) i dijastoličkog krvnog tlaka (PDKT), srednjeg arterijskog tlaka (MAP) te pulsnog tlaka (PP) za centralni (CMAP, CPP) i periferni krvni tlak (PMAP, PPP). Za procjenu sastava tijela korišten je Tanita MC780 Multi Frequency segmentni analizator pomoću kojeg su dobiveni podatci o tjelesnoj masnoći (kg, %) te masi visceralnog masnog tkiva. Rezultati: Od ukupnog broja ispitanika 21 (38,18%) ispitanik imao je RAH, a 17 (30,90 %) KBB. Usporedbom ispitivanih parametara s obzirom na postojanje RAH rezultati ukazuju kako su ispitanici s RAH bili statistički značajno stariji (P=0,032) dok značajne razlike u drugim ispitivanim parametrima nije zabilježeno. Rezultati su pokazali kako je 38 (69%) ispitanika imalo prekomjernu tjelesnu težinu (ITM ≥ 25 kg/m2), a među njima je 12 (22,64%) ispitanika bilo pretilo (ITM > 30 kg/m2). Statistički značajni pozitivni prediktori PSAT bili su ITM (β (SE) 1,71 (0,55), P= 0,003), opseg nadlaktice (β (SE) 0,95 (0,43), P= 0,032), opseg struka (β (SE) 0,41 (0,18), P= 0,025), WhTR (β (SE) 85,22 (36,2), P= 0,023), količina masnog tkiva izražena u postocima (β (SE) 0,6 (0,27), P=0.,030), količina masnog tkiva izražena u kilogramima (β (SE) 0,69 (0,25), P=0,008 te visceralno masno tkivo (β (SE) 1 (0,42), P=0,021) Nadalje, statistički značajni pozitivni prediktori CSAT su ITM (β (SE) 1,38 (0,55), P= 0,016) i opseg nadlaktice (β (SE) 1,02 (0,44), P= 0,025). Zaključak: Rezultati istraživanja pokazali su visoku učestalost RAH, KBB te prekomjerne težine i pretilosti u bolesnika s transplantiranim bubregom i AH te ukazali na njihovu moguću povezanost.Introduction:The aim of our study was to evaluate correlations between cardiovascular (CV) risk factors and parameters of nutritional status in renal transplant recipients (RTRs) with functioning kidney graft and arterial hypertension (AH). Materials and methods: Subjects of our study were 55 hypertensive RTRs, age median 63, of whom 33 men (60%) and 22 women (40%). Data about sex, age, body weight and height, waist circumference and upperarm circumference was collected and body mass index (BMI), waist-to-height ratio (WHtR) and glomerular filtration rate (eGFR) were calculated for each study subject. Also, data about length of dialysis treatment before kidney transplantation (KTX), time after KTX, quantity and type of antihypertensive drugs were collected as well as laboratory parameters. “Agedio B900” device was used for assessment of central and peripheral blood pressure and data about central systolic (CSBP) and diastolic blood pressure (CDBP), peripheral systolic (PSBP) and diastolic blood pressure (PDBP), mean arterial pressure (MAP), pulse pressure (PP) for central (CMAP, CPP) and peripheral blood pressure (PMAP, PPP) was collected. Body composition was assessed by Tanita MC780 Multi Frequency segment analyser and data about body fat (%, kg) and visceral body fat were collected. Results: Out of 55 RTRs, 21 (38.18%) had RAH, 17 (30.90 %) had CKD. When we compared assesed parameters regarding persistence of RAH, results showed that RTRs with RAH were statistically significantly older (P=0.032), but we found no further difference in nutritional status or CV risk parameters. Results showed that 38 (69%) RTRs were overweight (BMI ≥ 25 kg/m2) and among them 12 (22.64%) were obese (BMI > 30 kg/m2 ). Statistically significant positive predictors of PSBP were BMI (β (SE) 1,71 (0,55), P= 0,003), upperarm circumference (β (SE) 0,95 (0,43), P= 0,032), waist circumference (β (SE) 0,41 (0,18), P= 0,025), WhTR (β (SE) 85,22 (36,2), P= 0,023), fat mass in percentage (β (SE) 0,6 (0,27), P=0.,030), fat mass in kilograms (β (SE) 0,69 (0,25), P=0,008 and visceral fat tissue (β (SE) 1 (0,42), P=0,021) Furthermore, statistically significant positive predictors of CSBP were BMI (β (SE) 1,38 (0,55), P= 0,016) and upperarm circumference (β (SE) 1,02 (0,44), P= 0,025). Conclusion: Results of our study showed high prevalence of RAH, CKD, obesity and overweight in hypertensive RTRs and suggested possible interconnection between these parameters