Cholesterol as an Independent Predictor of Outcome After Renal Transplantation.

Roodnat, Joke I.; Mulder, Paul; Zietse, Robert; Rischen-Vos, J.; Van, Iza C. Riemsdijik; IJzermans, Jan N.M.; Weimar, Willem

doi:10.1097/00007890-200004271-00978

Cited by 17 publications

(23 citation statements)

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“…Hyperlipidemic and hypertensive eff ects of CyA increase the risk of posttransplant cardiovascular disease and as important nontraditional risk factors contribute to the high cardiovascular morbidity and mortality in renal transplant patients 4 . Hyperlipidemia and hypertension are also risk factors for chronic transplant nephropathy and reduce long term graft function and survival 5,6 . Gingival hyperplasia and hypertrichosis are known to reduce quality of life and may lead to non-compliance 7 .…”

Section: Improvement Of Cardiovascular Risk Factors and Cosmetic Sidementioning

confidence: 99%

Improvement of Cardiovascular Risk Factors and Cosmetic Side Effects in Kidney Transplant Recipients After Conversion to Tacrolimus

Zadrazil¹,

Horák²,

Zahálková³

et al. 2009

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims:Tacrolimus and Cyclosporine A (CyA) are cornerstones in immunosuppressive therapy. Cyclosporine side eff ects include hypertension and hypercholesterolemia both of which may increase the risk of cardiovascular mortality, gingival hyperplasia and hirsutism are known to reduce quality of life. The aim of this prospective study was to evaluate changes in cardiovascular risk profi le and cosmetic side eff ects after conversion from CyA to tacrolimus.Methods: 25 stable kidney transplant recipients (9 male, 16 female) were converted from a CyA to a tacrolimusbased regimen. Mean age was 45.7 ± 13.5 years. Time to switch following transplantation was 4.7±1.7 years. Reasons for conversion were multiple: arterial hypertension (9), hypertrichosis (3), gingival hyperplasia (3), hyperlipidemia (14).Results: 19/25 patients completed the one year study period. One patient died, two returned to hemodialysis, two were switched back to CyA and one patient was lost to follow-up. There were statistically signifi cant changes (p = < 0.05) in systolic and diastolic pressure and antihypertensive medication could be reduced in 13 patients. The dose of lipid-lowering agents could be reduced in the majority of the recipients and a complete withdrawal was achieved in 7 patients. Hypertrichosis and gingival hyperplasia resolved in all patients. Further, there was a signifi cant improvement (p = <0.05) in urea and serum creatinine levels. Adverse events were consistent with the established safety profi le for tacrolimus.Conclusions: Conversion to a tacrolimus-based regimen led to an improvement in the cardiovascular risk profi le. Further, cosmetic side eff ects which may lead to non-compliance, resolved after the switch.

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Section: Improvement Of Cardiovascular Risk Factors and Cosmetic Sidementioning

confidence: 99%

Improvement of Cardiovascular Risk Factors and Cosmetic Side Effects in Kidney Transplant Recipients After Conversion to Tacrolimus

Zadrazil¹,

Horák²,

Zahálková³

et al. 2009

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…proteinuria, chronic inflammation, increased oxidative stress, thrombogenic factors, hyperhomocysteinemia and anemia, may affect the incidence of cardiovascular disease in both chronic renal failure and end-stage kidney disease (1,2). Long-term patient survival in renal transplant recipients has already been linked to age, smoking, the severity of hypertension, the presence of hyperlipidemia, and diabetes mellitus (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Risk Factors and Estimated Risk for CAD in a Randomized Trial Comparing Calcineurin Inhibitors in Renal Transplantation

Krämer

Zülke

Kammerl

et al. 2003

American Journal of Transplantation

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Cardiovascular morbidity and mortality is high in patients following renal transplantation. The present analysis assessed major cardiovascular risk factors and estimated the risk of coronary artery disease in the largest present-day comparative trial of tacrolimus vs. microemulsified cyclosporine A.In this 6-month study, 557 patients were randomly allocated to therapy with tacrolimus (n = 286) or cyclosporine A (n = 271) concomitantly with azathioprine and corticosteroids. The primary endpoint was the incidence of and time to acute rejection. Blood pressure, serum cholesterol, HDL cholesterol, triglycerides, and blood glucose were measured at baseline, and at months 1, 3, and 6. Ten-year risk of coronary heart disease was estimated according to the Framingham risk algorithm.Tacrolimus resulted in significantly lower summary measures (time-weighted average) of serum cholesterol (p = 0.0004) and mean arterial blood pressure (p = 0.0156), but in a higher summary measure of blood glucose (p = 0.0028) than cyclosporine. The summary measure of serum triglycerides was not different between treatment groups (p = 0.368). The mean 10-year coronary artery disease risk estimate was significantly lowered in men (p = 0.0032) treated with tacrolimus, but was unchanged in women.Tacrolimus and cyclosporine A microemulsion exert a compound-specific impact on cardiovascular risk factors and appear to affect the predicted rate of cardiovascular morbidity in different manners.

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“…Generally, more than one of these factors (systemic arterial hypertension, diabetes mellitus, obesity, dyslipidemia, smoking, and family history) are found in renal transplant recipients [1][2][3] . Elevated serum levels of total cholesterol and LDL-cholesterol are frequent after renal transplantation, affecting more than 60% of these patients 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Avaliação dos níveis séricos de homocisteína em transplantados renais com e sem hipercolesterolemia

Piovesan¹,

Veronese²,

Santos³

et al. 2007

Arq. Bras. Cardiol.

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Cholesterol as an Independent Predictor of Outcome After Renal Transplantation.

Cited by 17 publications

References 0 publications

Improvement of Cardiovascular Risk Factors and Cosmetic Side Effects in Kidney Transplant Recipients After Conversion to Tacrolimus

Improvement of Cardiovascular Risk Factors and Cosmetic Side Effects in Kidney Transplant Recipients After Conversion to Tacrolimus

Cardiovascular Risk Factors and Estimated Risk for CAD in a Randomized Trial Comparing Calcineurin Inhibitors in Renal Transplantation

Avaliação dos níveis séricos de homocisteína em transplantados renais com e sem hipercolesterolemia

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