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Simultaneous Pancreas Kidney Transplantation Improves Cardiovascular Autonomic Neuropathy with Improved Valsalva Ratio as the Most Precocious Test

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Simultaneous Pancreas Kidney Transplantation Improves Cardiovascular Autonomic Neuropathy with Improved Valsalva Ratio as the Most Precocious Test

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dc.contributor.author Argente-Pla, M. es_ES
dc.contributor.author Pérez-Lázaro, Antonia es_ES
dc.contributor.author Martinez-Millana, Antonio es_ES
dc.contributor.author Del Olmo-García, María Isabel es_ES
dc.contributor.author Espí-Reig, Jordi es_ES
dc.contributor.author Beneyto-Castello, Isabel es_ES
dc.contributor.author López-Andújar, Rafael es_ES
dc.contributor.author Merino-Torres, J.F. es_ES
dc.date.accessioned 2021-05-27T03:35:45Z
dc.date.available 2021-05-27T03:35:45Z
dc.date.issued 2020-04-08 es_ES
dc.identifier.issn 2314-6745 es_ES
dc.identifier.uri http://hdl.handle.net/10251/166849
dc.description.abstract [EN] Background. Simultaneous pancreas-kidney (SPK) transplantation is a proven option of treatment for patients with type 1 diabetes mellitus (T1DM) and related end-stage renal disease. There is discrepancy between the results of different studies about the impact of prolonged normalization of glucose metabolism achieved by SPK on the course of diabetic complications including severe forms of diabetic neuropathy. The objective of the study was to evaluate the prevalence of cardiovascular autonomic neuropathy (CAN) in patients undergoing SPK transplantation and its evolution 10 years after transplantation. Methods. Prospective study of 81 patients transplanted in a single center from year 2002 to 2015. Autonomic function was assessed using cardiovascular autonomic reflex tests (CARTs). CARTs were made before SPK transplantation and during the follow-up. Evolution of tests after SPK transplantation was evaluated by contrasting hypotheses (paired tests). Multiple testing was adjusted with the Benjamini-Hochberg procedure with a false discovery rate of 10%. Results. 48 males and 33 females, mean age 37.4 +/- 5.7 years, mean BMI 24.0 +/- 3.4 kg/m2, and mean duration of diabetes 25.5 +/- 6.5 years, received SPK transplantation. Ten years after SPK transplantation, 56 patients re tained the pancreatic graft (42 of them with normofunctioning pancreas and 14 with low doses of insulin therapy). These 42 patients were selected for the autonomic study. Before transplant procedure, all CART results were abnormal. After SPK transplantation, paired test analysis showed an improvement of systolic blood pressure (SBP) response to orthostasis at the 5(th) year after SPK (p=0.03), as well as improvement of the Valsalva ratio at the 3(rd) (p<0.001) and 5(th) (p=0.001) year after SPK. After correcting for the false discovery rate, all the variables of autonomic study reached significance at different time points. Conclusions. Prevalence of CAN in patients who are candidates for SPK transplantation is high and is generally advanced. SPK transplantation improves CAN with improved Valsalva ratio as the most precocious test. es_ES
dc.language Inglés es_ES
dc.publisher Hindawi es_ES
dc.relation.ispartof Journal of Diabetes Research es_ES
dc.rights Reconocimiento (by) es_ES
dc.subject Diabetes-Mellitus es_ES
dc.subject Risk-Factors es_ES
dc.subject Dysfunction es_ES
dc.subject Complications es_ES
dc.subject Association es_ES
dc.subject Mortality es_ES
dc.subject Trial/Epidemiology es_ES
dc.subject Interventions es_ES
dc.subject Statement es_ES
dc.subject Diagnosis es_ES
dc.subject.classification TECNOLOGIA ELECTRONICA es_ES
dc.title Simultaneous Pancreas Kidney Transplantation Improves Cardiovascular Autonomic Neuropathy with Improved Valsalva Ratio as the Most Precocious Test es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.1155/2020/7574628 es_ES
dc.rights.accessRights Abierto es_ES
dc.contributor.affiliation Universitat Politècnica de València. Departamento de Ingeniería Electrónica - Departament d'Enginyeria Electrònica es_ES
dc.description.bibliographicCitation Argente-Pla, M.; Pérez-Lázaro, A.; Martinez-Millana, A.; Del Olmo-García, MI.; Espí-Reig, J.; Beneyto-Castello, I.; López-Andújar, R.... (2020). Simultaneous Pancreas Kidney Transplantation Improves Cardiovascular Autonomic Neuropathy with Improved Valsalva Ratio as the Most Precocious Test. Journal of Diabetes Research. 2020:1-10. https://doi.org/10.1155/2020/7574628 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion https://doi.org/10.1155/2020/7574628 es_ES
dc.description.upvformatpinicio 1 es_ES
dc.description.upvformatpfin 10 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 2020 es_ES
dc.identifier.pmid 32337297 es_ES
dc.identifier.pmcid PMC7168717 es_ES
dc.relation.pasarela S\407670 es_ES
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