Cardiovascular disease burden and risk factors before and after kidney transplant.
Cardiovascular (CV) disease is the most common cause of mortality among kidney transplant candidates on the waiting-list and after kidney transplantation. The mechanisms of cardiovascular disease burden after transplant are multifactorial and the risk is largely determined by pre-transplant factors including CV disease and dialysis duration. Current pre-transplant cardiac evaluation protocols have proven to be inconsistent in predicting adverse cardiovascular outcome post-transplant. However, multiple biomarkers have been recognized as predictors of all-cause mortality and cardiovascular events including graft function, hemoglobin, homocysteine, C - reactive protein among others. Of these, elevation in the biomarker cardiac troponin T appears to be a significant predictor of cardiovascular events and mortality among wait-listed kidney transplant candidates and after transplantation. The relationship between CV risk reduction, normalization of cardiac troponin T levels and restoration of renal function after kidney transplant is complex but opens opportunities for the use of cardiac troponin T and other cardiovascular biomarkers as important endpoints of clinical interventions in kidney transplant recipients.
Mira T
MT
Keddis
Gauri
G
Bhutani
Mayo Clinic Phoenix Campus, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA. Keddis.Mira@mayo.edu.
Ziad M
ZM
El-Zoghby
D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D017281:Cost of Illness; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery; D016030:Kidney Transplantation; D012307:Risk Factors
D015415:Biomarkers