Lifestyle behaviors affect cardiovascular risk status in men 1 year after kidney transplantation

Abstract

Persons with end-stage renal disease have an accelerated risk for cardiovascular (CV) morbidity and mortality. Unfortunately, their accelerated CV risk persists even after kidney transplantation associated with pretransplant and post-transplant vascular disease. number of rejections treated with high-dose steroids, prolonged use of immunosuppressive therapy post-transplant, effects of comorbid chronic conditions and male gender. Unhealthy, modifiable lifestyle practices often augment their CV risk. The purpose of this study was to examine health-related lifestyle behaviors and estimate CV risks of men 1 year following kidney transplantation. Using the Healthier People Network Health Risk Appraisal (HPN-HRA), we examined CV risk characteristics of 34 men (M age=47.3 years) enrolled in an urban, mid-southern transplant center. Participants were assessed via self-administered paper-and-pencil questionnaires and medical record review provided biological data for analyses. HPN-HRA software was used to analyze biological and behavioral characteristics to compute CV risk estimates. Data were analyzed using descriptive, inferential and correlational analyses. The majority of participants reported smoke cessation (n= 19) or never having smoked (n = 8), and consumption of one or less alcoholic drinks per week (n=28). On the other hand, increased risk for heart attack and stroke were associated with advancing age (P<0.0001), white race (P<0.05) and higher systolic blood pressure (P<0.01). While risk for heart attack was associated with current cigarette smoking (P<0.01), risk for stroke was not. Conversely, risk for stroke was associated with higher BMI (P<0.05), risk for heart attack was not. Thus, the study provides evidence that male kidney transplant survivors exhibit a significant number of non-modifiable and modifiable characteristics that contribute to their posttransplant CV risk.

Outcome of Heart Transplants 15 to 20 Years Ago: Graft Survival, Post-transplant Morbidity, and Risk Factors for Mortality

“…Concerning renal transplantation, history of smoking is associated with a risk of graft deficiency, 33 increased cardiovascular diseases, 34 and epidermoid-type cutaneous cancers 35 ; and concerning HTX, smoking increases the incidence of chronic rejection. 36 In hepatic transplantation, smoking history is closely related to increased vascular complications of the graft 37 and to epidermoid carcinoma.…”

Tobacco use before and after liver transplantation: A single center survey and implications for clinical practice and research

“…There have been several studies of tobacco use among patients who have received other types of solid organ transplants. For instance, tobacco use has been found to be associated with graft loss and mortality in renal transplant patients,10–11 graft loss in pancreas transplant patients,12 cardiovascular disease in renal transplant patients,13–15 and cancer in renal,16 lung,17 and heart18 transplant patients. Also noteworthy is that tobacco use has been associated with lower quality of life and lower quality of life benefit gained from surgical interventions 19–20…”

Nutritional management of dyslipidaemia in adult kidney transplant recipients

“…The diet should contain complex carbohydrates (50-60% of total calories) and [20][21][22][23][24][25][26][27][28][29][30] 39 Hyperlipidaemia risk profiles should be identified by regular screening (at least once a year) for cholesterol, HDL-cholesterol, LDLcholesterol, triglyceride blood levels in renal transplant patients.…”

“…[24][25][26][27][28][29][30] Guidelines for the management of dyslipidaemias in the general population make recommendations on diet and other aspects of lifestyle including exercise, body weight, alcohol consumption and smoking. 1,2,5,[31][32][33] The objective of this guideline is to ensure that appropriate dietary interventions are used to prevent and manage dyslipidaemia in adult kidney transplant recipients.…”

“…While dyslipidaemia and CVD are often present at the time of transplantation, immunosuppressive medications (such as calcineurin inhibitors, sirolimus and corticosteroids), lifestyle factors and post-transplant renal function are also implicated in abnormal serum lipid levels and CVD risk post-transplantation. [24][25][26][27][28][29][30] Guidelines for the management of dyslipidaemias in the general population make recommendations on diet and other aspects of lifestyle including exercise, body weight, alcohol consumption and smoking. …”