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Post-Transplant Metabolic Syndrome — ESENeph MCQ

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ModerateTransplantationPost-Transplant Metabolic SyndromeESENeph

A kidney transplant recipient on Tacrolimus develops significant post-transplant weight gain (15 kg over 2 years), dyslipidaemia, and hypertension. His eGFR is 52 mL/min/1.73m2. What is the risk of metabolic syndrome post-transplant?

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Correct answer: C — Metabolic syndrome affects 30-50% of transplant recipients; immunosuppressive agents (Tacrolimus, Prednisolone) contribute; it increases cardiovascular mortality which is the leading cause of graft loss and death post-transplant

Metabolic syndrome (obesity, dyslipidaemia, hypertension, insulin resistance) affects 30-50% of kidney transplant recipients. Contributing factors include Tacrolimus (diabetogenic), Prednisolone (weight gain, insulin resistance, dyslipidaemia), Sirolimus (hyperlipidaemia), reduced physical activity, and improved appetite post-uraemia. Cardiovascular disease is the leading cause of death and late graft loss in transplant recipients. Management includes lifestyle modification, statin therapy (ALERT trial), BP control, glycaemic management, and weight management (GLP-1 RAs are being studied post-transplant).

Reference: KDIGO 2009 – Transplant Guideline; Jardine et al 2011 – ALERT Trial