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Cardiovascular disease after renal transplantation
B L Kasiske1, C Guijarro, Z A Massy
1Department of Medicine, University of Minnesota College of Medicine, Minneapolis 55415, USA.
Journal of the American Society of Nephrology : JASN
|January 1, 1996
Summary
Cardiovascular disease remains a significant risk after kidney transplants. Diabetes, acute rejection, and specific lipid levels are key risk factors, highlighting needs for better prevention strategies.
Area of Science:
- Nephrology
- Cardiology
- Vascular Surgery
Background:
- Cardiovascular disease (CVD) is a leading cause of death post-renal transplantation.
- Understanding CVD pathogenesis and treatment after transplantation is crucial.
Purpose of the Study:
- To analyze risk factors for ischemic heart disease (IHD), cerebral vascular disease (CVD), and peripheral vascular disease (PVD) after renal transplantation.
- To identify pretransplant and posttransplant predictors of vascular complications.
Main Methods:
- Cox proportional hazards analysis of 706 renal transplant recipients functioning for at least 6 months.
- Inclusion of time-dependent variables measured at multiple intervals up to long-term follow-up (7.0 +/- 4.2 yr).
Main Results:
- Diabetes significantly increased risk for IHD (RR 3.25), cerebral vascular disease (RR 3.21), and peripheral vascular disease (RR 28.18).
- Acute rejection episodes elevated risk for IHD (RR 1.40) and cerebral vascular disease (RR 1.24).
- High-density lipoprotein cholesterol was a strong predictor for IHD; posttransplant vascular diseases predicted each other.
Conclusions:
- Cardiovascular disease incidence remains high after renal transplantation.
- Multiple risk factors, including diabetes and acute rejection, necessitate targeted prevention and treatment strategies.
- Further research into effective management of vascular risk factors post-transplant is warranted.