From Risk Assessment to Management: Cardiovascular Complications in Pre- and Post-Kidney Transplant Recipients: A...

Area of Science:

• Nephrology
• Cardiology
• Transplantation Medicine

Background:

• Kidney transplantation offers superior outcomes for chronic kidney failure over dialysis.
• Cardiovascular disease (CVD) is a primary cause of mortality and morbidity in kidney transplant recipients, impacting survival and graft success.
• Post-transplant CVD arises from traditional risk factors (hypertension, diabetes) and transplant-specific factors (CKD, immunosuppressants, vascular access).

Purpose of the Study:

• To provide a comprehensive overview of cardiovascular risk assessment in kidney transplant recipients.
• To review current and emerging strategies for managing post-transplant cardiovascular disease.
• To highlight the need for improved understanding and management of CVD complications like coronary artery disease, stroke, and peripheral artery disease.

Main Methods:

• This is a narrative review.
• Literature search on cardiovascular risk factors and management in kidney transplant recipients.
• Synthesis of current evidence and emerging therapeutic strategies.

Main Results:

• Accurate cardiovascular risk assessment is essential for managing comorbidities and detecting pre-transplant coronary artery disease.
• Emerging therapies like GLP-1 receptor agonists and SGLT2 inhibitors show promise but require further investigation in this population.
• Significant knowledge gaps persist in the optimal management of post-transplant CVD, including coronary artery disease, stroke, and peripheral artery disease.

Conclusions:

• Effective management of cardiovascular comorbidities and risk factors is vital for kidney transplant recipients.
• Further research is needed to establish the role of novel pharmacotherapies in mitigating CVD in this high-risk group.
• Addressing challenges in post-transplant CVD management is critical for enhancing long-term patient and graft survival.