Metabolic syndrome was found in about a third of pediatric kidney transplant recipients, with post-transplant weight gain (ΔBMI height-age Z-score) identified as a key independent determinant, while acute rejection was the independent predictor of left ventricular hypertrophy.
Metabolic syndrome was present in 28.1% of pediatric kidney transplant recipients at a median of 21.5 months post-transplant.
Hypertriglyceridemia was the most common individual component of metabolic syndrome, present in over half the cohort.
Post-transplant weight gain, measured as ΔBMI height-age Z-score, was significantly higher in the metabolic syndrome group and was an independent predictor of MS.
Acute rejection, not metabolic syndrome, was the independent predictor of left ventricular hypertrophy (LVH) in multivariate regression analysis.
All patients in the cohort had elevated carotid intima medial thickness (cIMT), indicating universal subclinical atherosclerotic burden.
Graft function (eGFR), triglyceride index, and hand grip strength did not differ significantly between the MS and non-MS groups.
This research examined how common metabolic syndrome (a cluster of conditions including high blood pressure, high blood sugar, abnormal cholesterol, and excess body fat) is in children who have received a kidney transplant, and what effect it has on heart health. Studying 32 pediatric kidney transplant recipients in India at a median of about 21 months after transplant, the researchers found that roughly 1 in 3 children had developed metabolic syndrome. High blood pressure was extremely common (nearly 69% of children), as was high triglycerides (53%), and all children showed thickening of the carotid artery wall — a sign of early cardiovascular disease risk. The study found that weight gain after transplant was the strongest driver of metabolic syndrome development, while a history of acute (sudden) rejection of the transplanted kidney was the key predictor of an enlarged heart muscle (left ventricular hypertrophy). Importantly, metabolic syndrome itself was not independently linked to heart enlargement when other factors were accounted for. Kidney graft function and muscle strength were similar whether or not a child had metabolic syndrome. This research suggests that monitoring and managing weight gain in children after kidney transplantation may be critical for reducing the risk of metabolic syndrome, and that preventing acute rejection episodes may help protect heart structure. The universal finding of thickened carotid arteries in all patients highlights that cardiovascular risk monitoring should be a routine part of care for all pediatric kidney transplant recipients, regardless of metabolic syndrome status.
Saha A, Champaneri B, Patel V, Shah H, Kapadia S, Vala K, et al.. (2026). Metabolic Syndrome and Cardiovascular Outcomes in Pediatric Kidney Transplant Recipients-A Cross-Sectional Study.. Pediatric transplantation. https://doi.org/10.1111/petr.70438