Macrovascular disease in Sri Lankan kidney transplant recipients.
BACKGROUND
Macrovascular diseases such as angina, myocardial infarction, stroke and peripheral occlusive arterial disease are common causes of mortality and morbidity in transplant patients.


OBJECTIVE
To study the frequency and determinants if vascular disease in Sri Lankan patients with renal transplants.


METHODS
A cohort of 237 renal transplant recipients (163 males (76%), mean age 35.09, SD 11.05 years).


METHODS
Patients under follow up at the Faculty of Medicine Transplant program.


METHODS
Prospective study of a cohort of patients.


RESULTS
Macrovascular diseases developed in 42% of transplant recipients. 5.6% had transient ischaemic attacks, 2.8% strokes, 18.2% angina, 8.4% myocardial infarctions, 2.3% underwent lower extremity amputations because of vascular insufficiency, 7% peripheral vascular occlusive disease and 49.5% were hypertensive. Male sex (odds ratio of 2.87, 95% CI 1.33-6.85, p = 0.006), serum cholesterol greater than 6.2 mmol/l at transplant (odds ratio 8.60, 95% CI 2.53-38.9, p = 0.0001) at 5 years after transplant (odds ratio 10.25, 95% CI 1.22-22.9, p = 0.01) were associated with a higher risk of macrovascular disease. Pre-transplant diabetes was associated with a higher risk of macrovascular disease and lower extremity amputation (odds ratio 4.53, 95% CI 1.32-6.76, p = 0.007).


CONCLUSIONS
Strategies to screen for and treat potential risk factors should form an integral part of the follow up for Sri Lankan and Asian kidney transplant recipients.
Lanerolle
R L
RL
Department of Clinical Medicine, Faculty of Medicine, Colombo.
Fernando
D J
DJ
Sheriff
M H
MH
D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D013188:Sri Lanka