Cardiovascular morbidity and risk factors in renal transplant patients

Aakhus, Svend; Dahl, Ketil; Widerøe, Tor Erik

doi:10.1093/ndt/14.3.648

Cited by 203 publications

(126 citation statements)

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“…Although kidney transplantation is the preferred treatment for patients with ESRD, successful transplantation is still associated with substantially elevated morbidity and mortality (2,3). Many renal transplant recipients (RTRs) have metabolic acidosis (4,5), which may adversely affect cardiometabolic processes, including BP and insulin resistance, as well as proper functioning of multiple tissues (4,6,7).…”

Section: Introductionmentioning

confidence: 99%

Dietary Acid Load and Metabolic Acidosis in Renal Transplant Recipients

Berg

Engberink

Brink

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Acidosis is prevalent among renal transplant recipients (RTRs) and adversely affects cardiometabolic processes. Factors contributing to acidosis are graft dysfunction and immunosuppressive drugs. Little is known about the potential influence of diet on acidosis in RTRs. This study examined the association of metabolic acid load with acidosis and with cardiovascular risk factors in RTRs and aimed to identify dietary factors associated with acidosis.Design, participants, setting, & measurements 707 RTRs were included. Metabolic acid load was assessed by measuring 24-hour urinary net acid excretion (NAE; i.e., titratable acid + ammonium 2 bicarbonate). Acidosis was defined as serum [HCO 3 2 ] , 24 mmol/L. BP and insulin resistance, reflected by hemoglobin A1c, were among cardiovascular risk factors. Diet was assessed with food-frequency questionnaires. Linear regression analysis was applied to investigate association between NAE and acidosis and between dietary factors and acidosis.Results Mean age 6 SD was 53613 years; 57% of patients were male. Acidosis was present in 31% of RTRs. NAE was associated with acidosis (serum HCO 3 2 : b=20.61; serum pH: b=20.010; both P,0.001). Patients with high intake of animal protein (i.e., from meat, cheese, and fish) and low intake of fruits and vegetables had significantly lower serum HCO 3 2 and serum pH. No associations were observed between NAE and cardiovascular risk factors, such as hypertension and insulin resistance.Conclusions In addition to conventional factors contributing to acidosis, diet might influence acid-base homeostasis in RTRs. Higher intake of fruits and vegetables and lower animal protein intake is associated with less acidosis in RTRs.

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Section: Introductionmentioning

confidence: 99%

Dietary Acid Load and Metabolic Acidosis in Renal Transplant Recipients

Berg

Engberink

Brink

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…In a single-center, retrospective study, the cumulative incidence of cerebral vascular disease was 15% by 15 years (619). In another study of 406 stable renal transplant patients, the prevalence of peripheral vascular disease at 4 years posttransplant was 3% (767).…”

Section: Recommendationsmentioning

confidence: 95%

“…plantation (616,617,619,766,767). In a single-center, retrospective study, the cumulative incidence of cerebral vascular disease was 15% by 15 years (619).…”

Section: Recommendationsmentioning

confidence: 99%

“…Few studies have examined the incidence and clinical correlates of PVD in patients with ESRD, before or after renal transplantation. However, existing data suggest that the incidence is high (616,617,619,767,(807)(808)(809)(810). In a recent retrospective study of 664 adult kidney transplant recipients, the cumulative incidence of PVD …”

Section: The Evaluation Of Renal Transplant Candidates: Clinical Pracmentioning

confidence: 99%

“…Two-thirds of patients with lower extremity amputations died within 2 years (809). Gender, diabetes, hypertension, lipid abnormalities and cigarette smoking appear to be risk factors for PVD in patients with ESRD (619,767,808,810). Among 129 diabetic (nΩ34) and nondiabetic (nΩ95) patients undergoing renal transplantation, preexisting PVD was associated with a shortened patient survival (811).…”

Section: Rationalementioning

confidence: 99%

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