title: Pre-Transplant Cardiovascular Risk Factors Affect Kidney Allograft Survival: A Multi-Center Study in Korea.
abstract: BACKGROUND
  Pre-transplant cardiovascular (CV) risk factors affect the development of CV events even after successful kidney transplantation (KT). However, the impact of pre-transplant CV risk factors on allograft failure (GF) has not been reported.
  
  
  RESULTS
  We analyzed the graft outcomes of 2,902 KT recipients who were enrolled in a multi-center cohort from 1997 to 2012. We calculated the pre-transplant CV risk scores based on the Framingham risk model using age, gender, total cholesterol level, smoking status, and history of hypertension. Vascular disease (a composite of ischemic heart disease, peripheral vascular disease, and cerebrovascular disease) was noted in 6.5% of the patients. During the median follow-up of 6.4 years, 286 (9.9%) patients had developed GF. In the multivariable-adjusted Cox proportional hazard model, pre-transplant vascular disease was associated with an increased risk of GF (HR 2.51; 95% CI 1.66-3.80). The HR for GF (comparing the highest with the lowest tertile regarding the pre-transplant CV risk scores) was 1.65 (95% CI 1.22-2.23). In the competing risk model, both pre-transplant vascular disease and CV risk score were independent risk factors for GF. Moreover, the addition of the CV risk score, the pre-transplant vascular disease, or both had a better predictability for GF compared to the traditional GF risk factors.
  
  
  CONCLUSIONS
  In conclusion, both vascular disease and pre-transplant CV risk score were independently associated with GF in this multi-center study. Pre-transplant CV risk assessments could be useful in predicting GF in KT recipients.
authors: Division of Nephrology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.|Department of Critical Care Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors: Jung Nam
authors: JN
authors: An
authors: Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon-do, Korea.
authors: Song Vogue
authors: SV
authors: Ahn
authors: Division of Nephrology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors: Jung Pyo
authors: JP
authors: Lee
authors: Department of Internal Medicine, Gyeongsang National University Hospital, Changwon, Korea.
authors: Eunjin
authors: E
authors: Bae
authors: Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Eunjeong
authors: E
authors: Kang
authors: Division of Cardiology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors: Hack-Lyoung
authors: HL
authors: Kim
authors: Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Yong-Jin
authors: YJ
authors: Kim
authors: Division of Nephrology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors: Yun Kyu
authors: YK
authors: Oh
authors: Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Yon Su
authors: YS
authors: Kim
authors: Department of Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea.
authors: Young Hoon
authors: YH
authors: Kim
authors: Division of Nephrology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors: Chun Soo
authors: CS
authors: Lim
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D006084:Graft Rejection / Q000209:etiology*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D018570:Risk Assessment; D016896:Treatment Outcome