Associations between pre-kidney-transplant risk factors and post-transplant cardiovascular events and death.
The prevalence of cardiovascular risk factors in renal transplant candidates is high. A better understanding of the relation between these risk factors and cardiovascular morbidity and mortality is mandatory to improve transplantation outcome. In this retrospective cohort study 2187 adult patients who received a first kidney transplant between 1984 and 1997 were included. We analyzed the incidence of post-transplant cardiovascular events and tried to identify independent pretransplant risk factors for post-transplant cardiovascular events and all-cause mortality. The cumulative incidence of post-transplant cardiovascular events was 40%. The incidence was highest in the first 3 months after transplantation. Independent pretransplant risk factors for a post-transplant cardiovascular event were diabetic nephropathy [Hazard ratio (HR) 3.02; 95% CI 2.85-3.98], claudication [HR 2.17 (1.42-3.31)], cardiac event [HR 1.76 (1.32-2.33)], cerebrovascular accident HR 1.53 (1.03-2.28), time-on-dialysis [HR 1.06 (1.02-1.11)], recipient age [HR 1.04 (1.04-1.05)], and body mass index [HR 1.03 (1.00-1.05)]. Diabetic nephropathy and cardiovascular disease were also important predictors for all-cause mortality. Diabetic nephropathy and cardiovascular disease were the most important predictors for cardiovascular events and all-cause mortality after renal transplantation. Early treatment of cardiovascular risk factors and pretransplant cardiovascular evaluation might improve transplantation outcome.
Aalten
Jeroen
J
Department of Nephrology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands. j.aalten@nier.umcn.nl
Hoogeveen
Ellen K
EK
Roodnat
Joke I
JI
Weimar
Willem
W
Borm
George F
GF
de Fijter
Johan W
JW
Hoitsma
Andries J
AJ
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends