Risk factors for cardiovascular events after successful renal transplantation.
BACKGROUND
Cardiovascular disease is a frequent cause of morbidity after renal transplantation. The aims of this study were to evaluate the incidence of cardiovascular events and to identify the main risk factors for cardiovascular complications and mortality in 2071 white adults with a renal transplant functioning for at least 1 year.


METHODS
Clinical events, routine biochemistry, and prescribed drugs at month 1, month 6, and yearly after transplantation were analyzed.


RESULTS
The incidence of cardiovascular events increased over time. At 15 years after transplantation, only 47% of surviving patients had not experienced any cardiovascular event. Risk factors associated with cardiovascular complications were male gender (P=0.04), age (P<0.0001), arterial hypertension before transplantation (P<0.0001), longer pretransplant dialysis (P<0.0001), cardiovascular event before transplantation (P<0.0001), older era of transplantation (P=0.0009), center-specific effect (P=0.003), posttransplant diabetes mellitus (P=0.01), increased pulse pressure after transplantation (P=0.02), intake of corticosteroids (P=0.016), intake of azathioprine (P=0.016), lower serum albumin after transplantation (P=0.004), and higher serum triglyceride levels after transplantation (P=0.007). The risk of death was increased in patients with low or elevated hematocrit, while it was minimal with values around 38%.


CONCLUSIONS
The occurrence of fatal and nonfatal cardiovascular events after successful renal transplantation not only relates to baseline cardiovascular risk factors present at transplantation, but also to immunosuppressive drugs and posttransplantation traditional and nontraditional risk factors.
Vanrenterghem
Yves F C
YF
Department of Nephrology, University Hospital of K.U. Leuven, Leuven, Belgium. yves.vanrenterghem@uz.kuleuven.be
Claes
Kathleen
K
Montagnino
Giuseppe
G
Fieuws
Steffen
S
Maes
Bart
B
Villa
Margarita
M
Ponticelli
Claudio
C
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology*; D006435:Renal Dialysis / Q000706:statistics & numerical data
D007166:Immunosuppressive Agents