Altered kidney graft high-energy phosphate metabolism in kidney-transplanted end-stage renal disease type 1 diabetic patients: A cross-sectional analysis of the effect of kidney alone and kidney-pancreas transplantation

Paolo Fiorina, Gianluca Perseghin, Francesco De Cobelli, Chiara Gremizzi, Alessandra Petrelli, Lucilla Monti, Paola Maffi, Livio Luzi, Antonio Secchi, Alessandro Del Maschio

Research output: Contribution to journalArticle

Abstract

OBJECTIVE - Diabetes, hypertension, dyslipidemia, obesity, nephrotoxicity of certain immunosuppressive drugs, and the persistence of a chronic alloimmune response may significantly affect graft survival in end-stage renal disease (ESRD) type 1 diabetic patients who have undergone kidney transplant. The aim of this study was to ascertain the impact of kidney alone (KD) or combined kidney-pancreas (KP) transplantation on renal energy metabolism. RESEARCH DESIGN AND METHODS - We assessed high-energy phosphates (HEPs) metabolism by using, in a cross-sectional fashion, 31P-magnetic resonance spectroscopy in the graft of ESRD type 1 diabetic transplanted patients who received KD (n = 20) or KP (n = 20) transplant long before the appearance of overt chronic allograft nephropathy (CAN). Ten nondiabetic microalbuminuric kidney transplanted patients and 10 nondiabetic kidney transplanted patients with overt CAN were chosen as controls subjects. RESULTS - Simultaneous KP transplantation patients showed a higher β-ATP/inorganic phosphorus (Pi) ratio (marker of the graft energy status) versus the other groups, and a positive correlation between β-ATP/Pi phosphorus ratio and A1C was found. In the analysis limited to the subgroup of normoalbuminuric patients, the difference in β-ATP/Pi was still detectable in KP patients compared with KD transplantation. CONCLUSIONS - KP transplantation was associated with better HEPs than in KD transplantation, suggesting that restoration of β-cell function positively affects kidney graft metabolism.

Original languageEnglish
Pages (from-to)597-603
Number of pages7
JournalDiabetes Care
Volume30
Issue number3
DOIs
Publication statusPublished - Mar 2007

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Pancreas Transplantation
Kidney Transplantation
Energy Metabolism
Chronic Kidney Failure
Cross-Sectional Studies
Phosphates
Transplants
Kidney
Adenosine Triphosphate
Phosphorus
Allografts
Pancreas
Graft Survival
Immunosuppressive Agents
Dyslipidemias
Research Design
Magnetic Resonance Spectroscopy
Obesity
Hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

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title = "Altered kidney graft high-energy phosphate metabolism in kidney-transplanted end-stage renal disease type 1 diabetic patients: A cross-sectional analysis of the effect of kidney alone and kidney-pancreas transplantation",
abstract = "OBJECTIVE - Diabetes, hypertension, dyslipidemia, obesity, nephrotoxicity of certain immunosuppressive drugs, and the persistence of a chronic alloimmune response may significantly affect graft survival in end-stage renal disease (ESRD) type 1 diabetic patients who have undergone kidney transplant. The aim of this study was to ascertain the impact of kidney alone (KD) or combined kidney-pancreas (KP) transplantation on renal energy metabolism. RESEARCH DESIGN AND METHODS - We assessed high-energy phosphates (HEPs) metabolism by using, in a cross-sectional fashion, 31P-magnetic resonance spectroscopy in the graft of ESRD type 1 diabetic transplanted patients who received KD (n = 20) or KP (n = 20) transplant long before the appearance of overt chronic allograft nephropathy (CAN). Ten nondiabetic microalbuminuric kidney transplanted patients and 10 nondiabetic kidney transplanted patients with overt CAN were chosen as controls subjects. RESULTS - Simultaneous KP transplantation patients showed a higher β-ATP/inorganic phosphorus (Pi) ratio (marker of the graft energy status) versus the other groups, and a positive correlation between β-ATP/Pi phosphorus ratio and A1C was found. In the analysis limited to the subgroup of normoalbuminuric patients, the difference in β-ATP/Pi was still detectable in KP patients compared with KD transplantation. CONCLUSIONS - KP transplantation was associated with better HEPs than in KD transplantation, suggesting that restoration of β-cell function positively affects kidney graft metabolism.",
author = "Paolo Fiorina and Gianluca Perseghin and {De Cobelli}, Francesco and Chiara Gremizzi and Alessandra Petrelli and Lucilla Monti and Paola Maffi and Livio Luzi and Antonio Secchi and {Del Maschio}, Alessandro",
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T1 - Altered kidney graft high-energy phosphate metabolism in kidney-transplanted end-stage renal disease type 1 diabetic patients

T2 - A cross-sectional analysis of the effect of kidney alone and kidney-pancreas transplantation

AU - Fiorina, Paolo

AU - Perseghin, Gianluca

AU - De Cobelli, Francesco

AU - Gremizzi, Chiara

AU - Petrelli, Alessandra

AU - Monti, Lucilla

AU - Maffi, Paola

AU - Luzi, Livio

AU - Secchi, Antonio

AU - Del Maschio, Alessandro

PY - 2007/3

Y1 - 2007/3

N2 - OBJECTIVE - Diabetes, hypertension, dyslipidemia, obesity, nephrotoxicity of certain immunosuppressive drugs, and the persistence of a chronic alloimmune response may significantly affect graft survival in end-stage renal disease (ESRD) type 1 diabetic patients who have undergone kidney transplant. The aim of this study was to ascertain the impact of kidney alone (KD) or combined kidney-pancreas (KP) transplantation on renal energy metabolism. RESEARCH DESIGN AND METHODS - We assessed high-energy phosphates (HEPs) metabolism by using, in a cross-sectional fashion, 31P-magnetic resonance spectroscopy in the graft of ESRD type 1 diabetic transplanted patients who received KD (n = 20) or KP (n = 20) transplant long before the appearance of overt chronic allograft nephropathy (CAN). Ten nondiabetic microalbuminuric kidney transplanted patients and 10 nondiabetic kidney transplanted patients with overt CAN were chosen as controls subjects. RESULTS - Simultaneous KP transplantation patients showed a higher β-ATP/inorganic phosphorus (Pi) ratio (marker of the graft energy status) versus the other groups, and a positive correlation between β-ATP/Pi phosphorus ratio and A1C was found. In the analysis limited to the subgroup of normoalbuminuric patients, the difference in β-ATP/Pi was still detectable in KP patients compared with KD transplantation. CONCLUSIONS - KP transplantation was associated with better HEPs than in KD transplantation, suggesting that restoration of β-cell function positively affects kidney graft metabolism.

AB - OBJECTIVE - Diabetes, hypertension, dyslipidemia, obesity, nephrotoxicity of certain immunosuppressive drugs, and the persistence of a chronic alloimmune response may significantly affect graft survival in end-stage renal disease (ESRD) type 1 diabetic patients who have undergone kidney transplant. The aim of this study was to ascertain the impact of kidney alone (KD) or combined kidney-pancreas (KP) transplantation on renal energy metabolism. RESEARCH DESIGN AND METHODS - We assessed high-energy phosphates (HEPs) metabolism by using, in a cross-sectional fashion, 31P-magnetic resonance spectroscopy in the graft of ESRD type 1 diabetic transplanted patients who received KD (n = 20) or KP (n = 20) transplant long before the appearance of overt chronic allograft nephropathy (CAN). Ten nondiabetic microalbuminuric kidney transplanted patients and 10 nondiabetic kidney transplanted patients with overt CAN were chosen as controls subjects. RESULTS - Simultaneous KP transplantation patients showed a higher β-ATP/inorganic phosphorus (Pi) ratio (marker of the graft energy status) versus the other groups, and a positive correlation between β-ATP/Pi phosphorus ratio and A1C was found. In the analysis limited to the subgroup of normoalbuminuric patients, the difference in β-ATP/Pi was still detectable in KP patients compared with KD transplantation. CONCLUSIONS - KP transplantation was associated with better HEPs than in KD transplantation, suggesting that restoration of β-cell function positively affects kidney graft metabolism.

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