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Abstract: SA-PO1078

Influence of Residual Metabolic Risk on Renal Graft Function in Kidney Transplant Recipients: A Five-Year Retrospective Cohort Study

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Author

  • Aguilar Mullisaca, Denise, Universidad Mayor de San Andres, La Paz, La Paz Department, Bolivia, Plurinational State of
Background

Residual metabolic risk (RMR), defined as persistent cardiovascular risk despite achieving treatment goals for traditional risk factors, has emerged as a critical determinant of allograft outcomes in kidney transplantation. Specific patterns of RMR, particularly dyslipidemia despite standard therapy, significantly impact renal graft function independent of immunological factors.

Methods

A single-center retrospective cohort study analyzing 131 living donor renal transplant recipients in the University Hospital of Clinics La Paz Bolivia, followed from 2018-2023, with 39 meeting inclusion criterio: age ≥18 years, intermediate-to-very high RMR classification, complete lipid profiles. Primary outcome was estimated glomerular filtration rate (eGFR) decline over the 5-year follow-up period. Statistical analysis employed chi-square and Spearman correlation using SPSS v25.

Results

The study cohort (mean age 37.5±7.2 years, 58% male) predominantly exhibited secondary glomerulopathy as primary diagnosis (p=0.068). Patients with intermediate RMR presented with baseline eGFR of 45.59±4.8 ml/min/1.73m2. The significant inverse relationship between RMR severity and allograft function (p=0.026), with greater eGFR decline correlating with progression to very high RMR, eGFR <30 ml/min/1.73m2. Despite lipid-lowering therapy, persistent LDL cholesterol elevations were associated with 25% reduction in eGFR over the study period (RR: 7.3; p=0.017).

Conclusion

Elevated residual metabolic risk independently predicts accelerated renal allograft dysfunction in living donor kidney transplant recipients, with a 25% decline in eGFR observed in patients with higher risk profiles. Data suggest that post-transplant metabolic monitoring and targeted management strategies beyond traditional lipid goals may represent an important opportunity to extend allograft longevity.

Digital Object Identifier (DOI)