INTRODUCTION: Posttransplant cardiovascular disease (CVD) is the leading cause of death in renal transplant (RT) recipients and is more evident in recipients with transplants from expanded criteria donors (ECD). OBJECTIVES: We analyzed the evolution of cardiovascular risk factors and their association with patient mortality. MATERIALS AND METHODS: We undertook a single-center, prospective study of RT patients (n = 360) between 1999 and 2006. These were 180 recipients with transplants from ECD and 180 controls. We analyzed the baseline characteristics and the cardiovascular risk factors: hypertension, diabetes, dyslipidemia, CVD, and anemia. Posttransplant analyses included the evolution of cardiovascular risk factors and causes of death. RESULTS: The mean age of the ECD was 63.5 ± 5.4 versus 32.0 ± 13.2 years in the non-ECD (P < .001) and the recipient ages were 58.4 ± 8.7 versus 40.8 ± 13.3 years, respectively (P < .001). The median interquartile range [IQR] dialysis time was 25 months (15-39) versus 20 months (12-44; P = .017). The pretransplant body mass index was 26.89 ± 3.91 versus 25.43 ± 4.72 kg/m(2) (P = .002); the median (IQR) number of antihypertensive drugs was two (1-2) versus two (1-2.75; P = .015); dyslipidemia was present in 32.5% versus 21.6% (P = .024), diabetes in 10.6% versus 5.6% (P = .087), and CVD in 13.3% versus 7.8% (P = .086). Treatment with erythropoiesis-stimulating agents (ESA) was received by 84.9% versus 83.9% (P = .857). Concerning transplantation, the mean follow-up was 64.3 ± 33.7 months. Hypertension was present at 3 and 5 years in 85.6% versus 69.5% (P = .001) and 87.9% versus 72.8% (P = .009), respiratory. Treatment with angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers at 3 and 5 years was 79.8% versus 64.5% and 85.6% versus 65%. Dyslipidemia was present at 5 years in 63.1% versus 58.0% (P = .482). De novo diabetes occurred in 16.7% versus 11.1% (P = .128), and CVD in 13.5% versus 4.5% (P = .003). Univariate and multivariate Cox regression proportional hazards models were constructed to analyze the factors associated with patient death. CONCLUSIONS: CVD is the most common cause of death in recipients of ECD, RT, 40% in the ECD group versus 28.6% in the control group. Tight control of cardiovascular risk factors and a good pretransplant patient selection contributed to the good results obtained.
INTRODUCTION: Posttransplant cardiovascular disease (CVD) is the leading cause of death in renal transplant (RT) recipients and is more evident in recipients with transplants from expanded criteria donors (ECD). OBJECTIVES: We analyzed the evolution of cardiovascular risk factors and their association with patient mortality. MATERIALS AND METHODS: We undertook a single-center, prospective study of RT patients (n = 360) between 1999 and 2006. These were 180 recipients with transplants from ECD and 180 controls. We analyzed the baseline characteristics and the cardiovascular risk factors: hypertension, diabetes, dyslipidemia, CVD, and anemia. Posttransplant analyses included the evolution of cardiovascular risk factors and causes of death. RESULTS: The mean age of the ECD was 63.5 ± 5.4 versus 32.0 ± 13.2 years in the non-ECD (P < .001) and the recipient ages were 58.4 ± 8.7 versus 40.8 ± 13.3 years, respectively (P < .001). The median interquartile range [IQR] dialysis time was 25 months (15-39) versus 20 months (12-44; P = .017). The pretransplant body mass index was 26.89 ± 3.91 versus 25.43 ± 4.72 kg/m(2) (P = .002); the median (IQR) number of antihypertensive drugs was two (1-2) versus two (1-2.75; P = .015); dyslipidemia was present in 32.5% versus 21.6% (P = .024), diabetes in 10.6% versus 5.6% (P = .087), and CVD in 13.3% versus 7.8% (P = .086). Treatment with erythropoiesis-stimulating agents (ESA) was received by 84.9% versus 83.9% (P = .857). Concerning transplantation, the mean follow-up was 64.3 ± 33.7 months. Hypertension was present at 3 and 5 years in 85.6% versus 69.5% (P = .001) and 87.9% versus 72.8% (P = .009), respiratory. Treatment with angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers at 3 and 5 years was 79.8% versus 64.5% and 85.6% versus 65%. Dyslipidemia was present at 5 years in 63.1% versus 58.0% (P = .482). De novo diabetes occurred in 16.7% versus 11.1% (P = .128), and CVD in 13.5% versus 4.5% (P = .003). Univariate and multivariate Cox regression proportional hazards models were constructed to analyze the factors associated with patientdeath. CONCLUSIONS: CVD is the most common cause of death in recipients of ECD, RT, 40% in the ECD group versus 28.6% in the control group. Tight control of cardiovascular risk factors and a good pretransplant patient selection contributed to the good results obtained.
Authors: Rizky I Sugianto; Bernhard M W Schmidt; Nima Memaran; Ali Duzova; Rezan Topaloglu; Tomas Seeman; Sabine König; Luca Dello Strologo; Luisa Murer; Zeynep Birsin Özçakar; Martin Bald; Mohan Shenoy; Anja Buescher; Peter F Hoyer; Michael Pohl; Heiko Billing; Jun Oh; Hagen Staude; Martin Pohl; Gurkan Genc; Günter Klaus; Caner Alparslan; Ryszard Grenda; Jacek Rubik; Kai Krupka; Burkhard Tönshoff; Elke Wühl; Anette Melk Journal: Pediatr Nephrol Date: 2019-12-07 Impact factor: 3.714
Authors: Matthew R Weir; Ellen D Burgess; James E Cooper; Andrew Z Fenves; David Goldsmith; Dianne McKay; Anita Mehrotra; Mark M Mitsnefes; Domenic A Sica; Sandra J Taler Journal: J Am Soc Nephrol Date: 2015-02-04 Impact factor: 10.121
Authors: Vincenzo Graziano; Claudio Buccelli; Emanuele Capasso; Francesco De Micco; Claudia Casella; Pierpaolo Di Lorenzo; Mariano Paternoster Journal: Open Med (Wars) Date: 2016-12-15
Authors: A Durrbach; J M Pestana; S Florman; M Del Carmen Rial; L Rostaing; D Kuypers; A Matas; T Wekerle; M Polinsky; H U Meier-Kriesche; S Munier; J M Grinyó Journal: Am J Transplant Date: 2016-06-09 Impact factor: 8.086
Authors: Andras T Deak; Francesca Ionita; Alexander H Kirsch; Balazs Odler; Peter P Rainer; Reinhard Kramar; Michael P Kubatzki; Katharina Eberhard; Andrea Berghold; Alexander R Rosenkranz Journal: Nephrol Dial Transplant Date: 2020-10-01 Impact factor: 5.992