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Updated: Feb 28, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Discussion on the risk factors of developing cardiovascular diseases (CVD) after the kidney transplantation
Kai Wang1, Qing-Shan Qu1, Shu-Zhai Miao1
1Department of Organ Transplantation, People's Hospital of Zhengzhou, Zhengzhou City, Henan Province, PR China.
Insights
Cardiovascular disease (CVD) affects nearly 20% of kidney transplant recipients. Key risk factors include older age, pre-existing diabetes, prior CVD, and post-transplant complications like graft dysfunction and acute rejection.
Area of Science:
- Nephrology
- Cardiology
- Transplantation Medicine
Background:
- Kidney transplantation is a life-saving procedure for end-stage renal disease.
- Cardiovascular disease (CVD) remains a significant cause of morbidity and mortality post-transplant.
- Identifying risk factors for post-transplant CVD is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the incidence and risk factors associated with developing cardiovascular disease (CVD) following kidney transplantation.
- To identify specific patient characteristics and post-operative events that predict CVD development.
Main Methods:
- Retrospective analysis of 1106 kidney transplant recipients at People's Hospital of Zhengzhou (July 2010 - Dec 2014).
- Utilized Cox proportional hazard model to identify risk factors for post-transplant CVD.
- Data collection and follow-up occurred at multiple intervals before and after transplantation.
Main Results:
- A total of 216 (19.5%) patients developed CVD post-kidney transplantation.
- Significant risk factors identified include: age > 50, pre-existing diabetes, prior CVD history, diabetic nephropathy as primary disease, prolonged pre-operative dialysis (>12 months), elevated post-operative serum creatinine (>200 μmol/L), delayed graft failure (DGF), acute rejection (AR), and renal allograft dysfunction.
- CVD was a major cause of mortality, accounting for 37.3% of post-operative deaths.
Conclusions:
- The incidence of CVD after kidney transplantation is substantial.
- Multiple factors, including patient-related and transplant-related complications, contribute to CVD risk.
- Targeting and managing these identified risk factors may reduce CVD incidence and improve long-term graft and patient survival.
Abstract:
To discuss the risk factors of developing cardiovascular disease (CVD) after the kidney transplantation. Retrospective analysis on the data of 1106 patients who had been underwent kidney allotransplantation in People's Hospital of Zhengzhou from July, 2010 to Dec, 2014 and conformed to the inclusion criteria was taken. Cox proportional hazard model was used to analyze the risk factors of developing CVD after the kidney transplantation. 7 days, 1 month, 3 months, 6 months and 12 months before and after the operation, the data collection and following-up visits were respectively arranged. 12 months after the operation, the following-up visits were arranged once a half year until the end of March, 2014. 216 (19.5%) patients developed CVD after the kidney transplantation. Among them, 47 (4.2%) patients developed CVD within the first three months after the operation, which accounted for 26.8% in the CVD patients; 125 (11.3%) patients developed CVD within the first one year after the operation, which accounted for 47.9% in the CVD patients. 51 (4.6%) patients died after the operation. Among them, 19 (2.7%) patients died of CVD, which accounted for 37.3% in the whole died patients. Multiple factors analysis revealed that the following were the risk factors to develop CVD after the kidney transplantation: The age of receptors was greater than 50 (OR=2.39, 95%CI 1.15-3.60); The receptors had diabetes before the surgery (OR=3.18, 95%CI 1.56-6.42); The receptors had CVD medical history before the surgery (OR=3.85, 95%CI 2.15-7.54); The primary diseases of receptors were diabetic nephropathy (DN) (OR=2.12, 95%CI 1.14-3.98); The preoperative dialysis time was greater than 12 months(OR=1.27, 95%CI 0.98-1.38); The postoperative serum creatinine of the receptors was greater than 200 μmol/L (OR=2.78, 95%CI 1.35~4.53); The delayed graft failure (DGF) occurred (OR=1.24, 95%CI 1.02~1.42); Acute rejection appeared(AR)(OR=2.98, 95%CI 1.56~5.72); Renal allograft dysfunction appeared (OR=4.86, 95%CI 3.15~7.78). The morbidity of CVD is high after the kidney transplantation and the risk factors are diversified. That revising or excluding relevant risk factors may lower the morbidity of developing CVD and is in favor of the long-term survival for the transplanted kidney.
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