Prediabetic States, Subclinical Atheromatosis, and Oxidative Stress in Renal Transplant Patients

Osorio, J.M.; Ferreyra, C.; Pérez, Ángela Fraga; Moreno, Juan Manuel; Osuna, Antonio

doi:10.1016/j.transproceed.2009.06.002

Cited by 12 publications

(7 citation statements)

References 13 publications

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“…Accordingly, individuals with a persistently high or increased c-IMT experienced a higher mortality in the univariate analysis. These findings agree with previous studies [13, 14, 16], and underscore the enhanced cardiovascular risk in this population, especially due to immunosuppressant side effects. Both immunosuppression-related insulin resistance and hyperglycemia may accelerate the development of atherosclerosis by triggering inflammation pathways leading to increased mortality over time, as reported [36–38].…”

Section: Discussionsupporting

confidence: 93%

Artery Wall Assessment Helps Predict Kidney Transplant Outcome

et al. 2015

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BackgroundKidney transplant recipients have high cardiovascular risk, and vascular inflammation may play an important role. We explored whether the inflammatory state in the vessel wall was related to carotid intima-media thickness (c-IMT) and patient survival following kidney transplantation.MethodsIn this prospective observational cohort study we measured c-IMT and expression of proinflammatory cytokines and adhesion molecules in the inferior epigastric artery in 115 kidney transplant candidates. Another c-IMT measurement was done 1-year post-transplantation in 107. By stepwise multiple regression analysis we explored factors associated with baseline c-IMT and their changes over time. Multivariate Cox regression analysis was constructed to identify risk factors for mortality.ResultsA worse cardiovascular profile (older age, smoker, diabetic, carotid plaque, systolic blood pressure and vascular calcification) and higher VCAM-1 levels were found in patients in the highest baseline c-IMT tertile, who also had a worse survival. Factors independently related to baseline c-IMT were age (β=0.369, P<0.0001), fasting glucose (β=0.168, P=0.045), smoking (β=0.228, P=0.003) and VCAM-1 levels (β=0.244, P=0.002). Independent factors associated with c-IMT measurement 1-year post-transplantation were baseline c-IMT (β=-0.677, P<0.0001), post-transplant diabetes (β=0.225, P=0.003) and triglycerides (β=0.302, P=0.023). Vascular VCAM-1 levels were associated with increased risk of mortality in bivariate and multivariate Cox regression. Notably, nearly 50% of patients showed an increase or maintenance of high c-IMT 1 year post-transplantation and these patients experienced a higher mortality (13 versus 3.5%; P=0.021).ConclusionA worse cardiovascular profile and a higher vascular VCAM-1 protein levels at time of KT are related to subclinical atheromatosis. This could lead to a higher post-transplant mortality. Pre-transplant c IMT, post-transplant diabetes and triglycerides at 1-year post-transplantation may condition a high c-IMT measurement post-transplantation, which may decrease patient survival.

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Section: Discussionsupporting

confidence: 93%

Artery Wall Assessment Helps Predict Kidney Transplant Outcome

et al. 2015

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“…Thus, in moving forward, the programmatic schema for the reduction in CVEs in pediatric KT recipients must entail aggressive implementation of conventional treatment and surveillance guidelines such as frequent cardiac rhythm assessment, low dose aspirin, and statin administration. This screening and prophylactic program, combined with the utilization of newer less‐invasive technologies, may yield an earlier diagnosis and potential amelioration of the ramifications from CVD.…”

Section: Discussionmentioning

confidence: 99%

Incidence and magnitude of post‐transplant cardiovascular disease after pediatric kidney transplantation: Risk factor analysis of 1058 pediatric kidney transplants at the university of Minnesota

Serrano

Bangdiwala

Vock

et al. 2018

Pediatric Transplantation

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“…However, whether immunological parameters, inflammatory cytokines, and lipid peroxidation influence CIMT remains unknown. Inflammatory cytokines such as CRP [ 43 , 116 ] and lipid peroxidation levels [ 117 ] correlated with increases in CIMT. However, another study showed that the distributions of MnSOD, GSTM1 and GSTP1 genotypes according to CIMT, plaque type or plaque score did not significantly differ [ 118 ].…”

Section: The Associations Between Cimt and Novel Risk Factorsmentioning

confidence: 99%

Causes of changes in carotid intima-media thickness: a literature review

2015

Cardiovasc Ultrasound

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Atherosclerosis causes significant morbidity and mortality. Carotid intima-media thickness (CIMT) predicts future cardiovascular and ischaemic stroke incidence. CIMT, a measure of atherosclerotic disease, can be reliably determined in vivo by carotid ultrasound. In this review, we determined that CIMT is associated with traditional cardiovascular risk factors such as age, sex, race, smoking, alcohol consumption, habitual endurance exercise, blood pressure, dyslipidemia, dietary patterns, risk-lowering drug therapy, glycemia, hyperuricemia, obesity-related anthropometric parameters, obesity and obesity-related diseases. We also found that CIMT is associated with novel risk factors, including heredity, certain genotypic indices, anthropometric cardiovascular parameters, rheumatoid arthritis, immunological diseases, inflammatory cytokines, lipid peroxidation, anthropometric hemocyte parameters, infectious diseases, vitamin D, matrix metalloproteinases, and other novel factors and diseases. However, the conclusions are inconsonant; the underlying causes of these associations remain to be further explored.

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Prediabetic States, Subclinical Atheromatosis, and Oxidative Stress in Renal Transplant Patients

Cited by 12 publications

References 13 publications

Artery Wall Assessment Helps Predict Kidney Transplant Outcome

Artery Wall Assessment Helps Predict Kidney Transplant Outcome

Incidence and magnitude of post‐transplant cardiovascular disease after pediatric kidney transplantation: Risk factor analysis of 1058 pediatric kidney transplants at the university of Minnesota

Causes of changes in carotid intima-media thickness: a literature review

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