Cardiovascular complications after renal transplantation

Aker, Sendogan; Ivens, Katrin; Guo, Zhen; Grabensee, B; Heering, Peter

doi:10.1016/s0041-1345(98)00531-4

Cited by 51 publications

(33 citation statements)

References 9 publications

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“…This finding can be attributed to the high percentage of transplant recipients with hypertension both before and after transplantation, which makes this factor have little discriminating capacity, or to the systematic treatment of hypertension that reduces the adverse effects in this population. Cigarette smoking has been associated with posttransplantation IHD (6,7,10) and with mortality (24,25). Our data confirmed the association between smoking and IHD.…”

Section: Discussionsupporting

confidence: 86%

“…The incidence of AMI in our patients is lower than that observed in other published series (7-9,12). The differences could be attributed partially to the prevalence of pretransplantation diabetes (7,8) or cardiovascular disease before transplantation (7) and to dietetic, environmental, genetic, or other unknown factors that could reduce the risk for development of the disease, because age at transplantation, length of follow-up, gender distribution, and immunosuppression and prevalence of some risk factors before and after transplantation were similar to the majority of studies. More than one third of the events occurred during the first year (10), which could indicate that the disease was not under proper control at the time of transplantation; an inadequate pretransplantation evaluation of the recipient; or stress of surgery, immunosuppression, and other factors (17).…”

Section: Discussionmentioning

confidence: 81%

“…Age was an independent risk factor for IHD in several studies (6,8 -12) as well as male gender (8,11,12) and obesity (7). A history of cardiovascular disease before transplantation also was associated with IHD (11,12), but it disappeared from the model when only late events were analyzed.…”

Section: Discussionmentioning

confidence: 95%

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Ischemic Heart Disease after Renal Transplantation in Patients on Cyclosporine in Spain

Marcén¹,

Morales²,

Arias³

et al. 2006

Journal of the American Society of Nephrology

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Ischemic heart disease (IHD), more common among transplant recipients than in the general population, accounts for approximately 50% of cardiovascular deaths. Despite its importance, only a few publications have addressed the prevalence of and risk factors for this complication. This was a retrospective cohort study in 2382 cadaver renal transplant recipients who were treated with cyclosporine as initial immunosuppression. Two groups were formed. The first group consisted of 163 patients with IHD, and the second group consisted of 326 patients without IHD. The prevalence of IHD was 6.8%, and the incidence was 15.7/1000 patient-years. Cardiac events presented during the first year in 62 (38%) patients. Multivariate analysis showed that the risk factors for IHD were age at transplant in years (relative risk [RR] 1.054; 95% confidence interval [CI] 1.033 to 1.075; P ‫؍‬ 0.000), male gender (RR 1.940; 95% CI 1.221 to 3.081; P ‫؍‬ 0.005), body weight at transplant in kg (RR 1.020; 95% CI 1.007 to 1.033; P ‫؍‬ 0.002), pretransplantation cardiovascular disease (RR 2.150; 95% CI 1.733 to 3.359; P ‫؍‬ 0.001), and a history of pretransplantation hypercholesterolemia (RR 2.032; 95% CI 1.378 to 2.998; P ‫؍‬ 0.000). When only ischemic events that occurred 12 mo after transplantation were taken into consideration, the risk factors were age, male gender, body weight, smoking, and pretransplantation and posttransplantation hypercholesterolemia, whereas pretransplantation cardiovascular disease disappeared from the model. IHD affected nearly 7% of transplant recipients. Smoking, hypertension, and hypercholesterolemia constituted the treatable risk factors for IHD in this population. Emphasis should be placed on the need to stop smoking and to control hypertension and pre-and posttransplantation levels of serum cholesterol. C ardiovascular diseases are the most frequent cause of mortality in both dialysis and transplant patients in Europe (1) and account for at least one third of all deaths (2-5). Approximately 50% of these deaths in renal transplant recipients are due to ischemic heart disease (IHD). This increased mortality can be explained by the high prevalence of IHD after renal transplantation that has been reported to be three to four times higher than in the general population (6). Moreover, several risk factors for IHD that have been identified in the general population, such as older age, male gender, diabetes, previous cardiovascular disease, smoking, and hypercholesterolemia, are very common in transplant recipients, and they also have been identified as risk factors in this population (6 -13). The prevalence of IHD in the general population varies from country to country (14), and this also can be the case in transplant recipients. Despite the importance of IHD as a cause of death, data concerning the prevalence, incidence, and risk factors are scarce, and most of them are from North European and American countries (6 -12). As a result of these considerations, the present study was performed to (1) analyze the preval...

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 81%

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Ischemic Heart Disease after Renal Transplantation in Patients on Cyclosporine in Spain

Marcén¹,

Morales²,

Arias³

et al. 2006

Journal of the American Society of Nephrology

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“…Therefore, renal transplantation is the treatment of choice for many patients in this group [1]. However, several prospective studies among renal transplant recipients demonstrated that increased incidence of CVD are still present after transplantation [3][4][5][6]. Traditional risk factors such as hypertension (HT), diabetes mellitus (DM), hyperlipidemia (HL), and non-traditional risk factors such as anemia, hyperhomocysteinemia, inflammatory state, impaired coagulation and increased oxidative stress are well-recognized risk factors for the development of cardiovascular complications after renal transplantation [7].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Evaluation of Renal Transplant Recipients

Gülmez¹

2017

J Clin Exp Cardiolog

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Cardiovascular disease (CVD) is one of the major causes of death among renal transplant recipients. Moreover, several prospective studies among renal transplant recipients showed that increased incidence of CVD is still present after transplantation. Therefore, evaluation for the presence of CVD before transplantation is strongly advised. Although several screening tests are used for the detection of CVD, the relative performance of these tests for coronary artery disease (CAD) is uncertain. This review discusses the definition, risk factors, epidemiology, and the most used screening tests that might help cardiologists in providing information about the diagnosis and risk stratification before renal transplantation.

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“…1 However, there are conflicting results in studies reviewing the effects of obesity on outcomes following kidney transplantation. 63 A retrospective review of 427 kidney transplant recipients between 1987 and 1992 reported that 50 of their participants developed atherosclerotic CAD in the posttransplant follow-up period, which was 28.6 ± 20.2 months. Coronary artery disease occurred more frequently (9.8%), in their participants.…”

Section: 262mentioning

confidence: 99%

Characterizing Dietary Intake and Physical Activity Affecting Weight Gain in Kidney Transplant Recipients

Cupples¹

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Cardiovascular complications after renal transplantation

Cited by 51 publications

References 9 publications

Ischemic Heart Disease after Renal Transplantation in Patients on Cyclosporine in Spain

Ischemic Heart Disease after Renal Transplantation in Patients on Cyclosporine in Spain

Cardiovascular Evaluation of Renal Transplant Recipients

Characterizing Dietary Intake and Physical Activity Affecting Weight Gain in Kidney Transplant Recipients

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