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Updated: Jun 26, 2026
A Rat Orthotopic Renal Transplantation Model for Renal Allograft Rejection
Published on: February 2, 2022
Cerebrovascular events in renal transplant recipients
Sadollah Abedini1, Ingar Holme, Bengt Fellström
1Department of Medicine, Renal Section, National Hospital, Oslo, Norway. sadollah.abedini@gmail.com
Insights
Cerebrovascular events (CBV) in renal transplant recipients did not differ between fluvastatin and placebo groups. Risk factors for ischemic and hemorrhagic CBV events varied by subtype in this large trial.
Area of Science:
- Nephrology
- Neurology
- Cardiology
Background:
- Cerebrovascular (CBV) events in renal transplant recipients lack large prospective controlled trial data.
- Risk factors for different CBV subtypes remain underexplored in this population.
Purpose of the Study:
- To examine the incidence of stroke and risk factors for ischemic and hemorrhagic CBV events.
- To analyze outcomes in renal transplant recipients within the Assessment of Lescol in Renal Transplantation trial.
Main Methods:
- A randomized, double-blind, placebo-controlled study involving 2102 renal graft recipients.
- Mean follow-up of 6.7 years, including a 2-year open-label fluvastatin extension.
- Investigated incidence and risk factors for ischemic and hemorrhagic CBV events.
Main Results:
- No difference in CBV event incidence or type between fluvastatin and placebo arms.
- 184 patients (8.8%) experienced a CBV event; incidence was 1.3% per year.
- Mortality: 48% for hemorrhagic stroke, 6.0% for ischemic stroke.
- Independent risk factors for ischemic CBV: diabetes mellitus, prior CBV, age, serum creatinine.
- Risk factors for hemorrhagic CBV: diabetes mellitus, polycystic kidney disease, left ventricular hypertrophy, systolic blood pressure.
Conclusions:
- Risk factors for cerebrovascular events in renal transplant recipients are subtype-specific.
- Identified distinct risk profiles for ischemic versus hemorrhagic stroke in this cohort.
Background:
The incidence of stroke and risk factors for different subtypes of cerebrovascular (CBV) events in renal transplant recipients have not been examined in any large prospective controlled trial.
Methods:
The Assessment of Lescol in Renal Transplantation was a randomized, double-blind, placebo-controlled study of the effect of fluvastatin (40-80 mg) daily on cardiovascular, and renal outcomes in renal transplant recipients. Patients initially randomized to fluvastatin or placebo in the 5 to 6 year trial was offered open-label fluvastatin in a 2-year extension to the original study. We investigated the incidence of stroke and risk factors for ischemic and hemorrhagic CBV events in 2102 renal graft recipients participating in the Assessment of Lescol in Renal Transplantation core and extension trial with a mean follow-up of 6.7 years.
Results:
The incidence and type of CBV events did not differ between the lipid lowering arm and the placebo arm. A total of 184 (8.8%, 95% confidence interval 4.6-12.9) of 2102 patients experienced a CBV event during follow-up, corresponding to an incidence of 1.3% CBV event per year. The mortality for patients experiencing a hemorrhagic stroke was 48% (13 of 27), whereas the mortality for ischemic strokes was 6.0% (8 of 133). Diabetes mellitus, previous CBV event, age, and serum creatinine were independent risk factors for cerebral ischemic events. The risk of a hemorrhagic cerebral event was increased by diabetes mellitus, polycystic kidney disease, left ventricular hypertrophy, and systolic blood pressure.
Interpretation:
Risk factors for CBV events in renal transplant recipients differ according to subtype.
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