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Том 17 №3 2015 год - Нефрология и диализ

Факторы риска развития впервые возникшего сахарного диабета после трансплантации почки у детей


Галкина А.О. Петросян Э.К. Румянцев А.Л. Молчанова Е.А. Молчанова М.С. Валов А.Л. Шумилов П.В.

Аннотация: Сахарный диабет после трансплантации органов (СДПТ) - известное осложнение иммуносупрессивной терапии, являющееся фактором, влияющим на выживаемость аллотрансплантата, хорошо исследованное во взрослой популяции, но меньше в педиатрической. Цель исследования. Определить частоту встречаемости СДПТ и факторы, влияющие на его развитие у детей после аллотрансплантации трупной почки, а также влияние сахарного диабета после трансплантации на выживаемость аллотрансплантата. Материалы и методы. За период с 2008 по 2013 гг. нами проанализированы данные генеалогического анамнеза, лабораторных показателей: уровень глюкозы, холестерина, триглицеридов, мочевины, креатинина, наличие и степень активности ЦМВ, определенную ПЦР-методом до и после трансплантации, а также массо-ростовые показатели с определением ИМТ у 164 детей с аллотрансплантатом почки. Результаты. Частота развития СД у детей с аллотрансплантатом почки составила 9,76%. Среди факторов риска СДПТ нами достоверно выявлены наследственная предрасположенность к сахарному диабету (СД), метаболическому синдрому (МС) (р=0,042 и р=0,048, соответственно), более высокий ИМТ (р=0,009). Более того, продемонстрировано, что возникший после трансплантации почки СД у детей снижает выживаемость аллотрансплантата (p=0,01).

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Ключевые слова: сахарный диабет после трансплантации почки, ИМТ, метаболический синдром, выживаемость аллотрансплантата, New-Onset Diabetes After kidney Transplantation, BMI, metabolic syndrome, allograft survival

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