Risk Factors for Cardiovascular Disease in Children and Young Adults after Renal Transplantation

Becker-Cohen, Rachel; Nir, Amiram; Rinat, Choni; Feinstein, Sofia; Algur, Nurit; Farber, Benjamin; Frishberg, Yaacov

doi:10.2215/cjn.01480506

Cited by 49 publications

(41 citation statements)

References 41 publications

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“…a value slightly lower than what was found in the present study. Becker-Cohen et al 38 evaluated the 6MWT in children and young adults with CKF and with kidney transplants who were still undergoing dialysis. They found values within normality and, although there were no specific predictive values for children, they found that on average, the distance that they were able to walk was only 100 meters less than what the adults who were evaluated could achieve.…”

Section: Discussionmentioning

confidence: 99%

Efeitos negativos da insuficiência renal crônica sobre a função pulmonar e a capacidade funcional

Cury¹,

Brunetto²,

Aydos

2010

Rev. bras. fisioter.

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Objective: To evaluate lung function and functional capacity in patients with chronic kidney failure (CKF) undergoing dialysis and in patients after kidney transplant. Methods: Seventy-two participants were evaluated: 32 patients with CKF on dialysis (DG) for at least six months, ten patients who had kidney transplants (TG) at least six months earlier, and 30 healthy subjects as a control group (CG). all groups were evaluated using spirometry, with maximum inspiratory pressure (mIP) and maximum expiratory pressure (mEP), and using the six-minute walking test (6mWT). The SPSS 12.0 software was used for statistical analysis, with a minimum significance level of α<0.05. Results: There was a decreased lung function in the DG for FVC, FEV1, mVV, VC, mIP and mEP, and decreased FEV1 and mVV in the TG compared to the CG (one-way aNOVa/Fisher's post-hoc; p<0.01). There was also an association (chi-square) between decreased mIP and belonging to the DG ‫,5.0=ג(‬ p<0.001), between lower performance in the 6mWT for the DG and TG (p<0.01) compared to the CG (one-way aNOVa/Fisher's post-hoc), and between mIP and mEP (Pearson's coefficient; r=0.752; p<0.01). Conclusions:Patients with CKF undergoing dialysis showed impaired functional capacity and lung function that were not completely reverted in the kidney transplant patients.Key words: dialysis; kidney transplant; spirometry; respiratory muscles; functional capacity. ResumoObjetivo: avaliar a função pulmonar e a capacidade funcional em pacientes com insuficiência renal crônica (IRC) em hemodiálise e em pacientes após transplante renal. Métodos: Foram avaliados 72 indivíduos, sendo 32 pacientes com IRC em hemodiálise (GD) há mais de 6 meses, 10 pacientes transplantados renais (GT) há, pelo menos, 6 meses e 30 sujeitos saudáveis para grupo controle (GC). Todos os grupos foram avaliados utilizando espirometria, pressões inspiratória (PImax) e expiratória (PEmax) máximas e teste da caminhada em seis minutos (TC6min). Para análise estatística, foi utilizado o programa SPSS 12.0, com nível mínimo de significância α<0,05. Resultados: Foram encontrados resultados estatisticamente significativos (p<0,01) para: diminuição da função pulmonar no GD para Capacidade vital forçada (CVF), Volume expirado forçado (VEF1), Ventilação voluntária máxima (VVm), Capacidade vital (CV), PImax, PEmax e, para o GT, diminuição do VEF1 e VVm, quando comparados ao GC (aNOVa uma via/post hoc Fischer); associação (qui-quadrado) entre diminuição da PImax e pertencer ao GD ‫,5,0=ג(‬ p<0,001); menor desempenho no TC6min no GD e GT (p<0,01) quando comparados ao GC (aNOVa uma via/post hoc Fischer). Encontrou-se correlação significativa (coeficiente de Pearson) entre PImax e PEmax (r=0,752, P<0,01). Conclusões: Pode-se concluir que existem alterações na capacidade funcional e na função pulmonar do paciente com IRC em hemodiálise, as quais são indicativas de prejuízos funcionais que não se apresentam completamente revertidos no paciente transplantado renal.

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Section: Discussionmentioning

confidence: 99%

Efeitos negativos da insuficiência renal crônica sobre a função pulmonar e a capacidade funcional

Cury¹,

Brunetto²,

Aydos

2010

Rev. bras. fisioter.

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“…We defined normal LDL as <100mg/dL, in keeping with recent studies; the more stringent cutoff is recommended for high-risk populations of children and young adults. 32,33 The mean age of our survivors was >20 years. Body surface area (BSA) was calculated as (W 0.425 3 H 0.725 ) 3 0.007184, where W is the weight in kilograms and H is the height in centimeters; BSA was categorized as low (<1.62 m 2 ), normal (1.62-1.99 m 2 ), or high (2-2.90 m 2 ) according to recent recommendations.…”

Section: Perceived Physical Healthmentioning

confidence: 99%

Subclinical late cardiac toxicity in childhood cancer survivors

Cox

Shesh

Rosenthal

et al. 2008

Cancer

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BACKGROUNDThe authors analyzed how self‐reported health and self‐reported modified New York Heart Association (NYHA) cardiac function scores were related to cardiac systolic function, cardiac risk factors, and cancer treatment history in childhood cancer survivors who reported no symptoms of cardiac disease.METHODSLong‐term survivors of pediatric cancer who were treated between 1971 and 1995 (current ages, 16–39.7 years) underwent noninvasive clinical and laboratory cardiac risk evaluation and responded to selected subscales of the Medical Outcomes Study 36‐item Short Form Health Survey. Results were compared with survivor history of anthracycline therapy alone or with radiotherapy (n = 127 patients; mean, 10 years after diagnosis) versus no anthracycline therapy (n = 32 patients; mean, 11 years after diagnosis).RESULTSSex, current age, highest school grade completed, race, age at diagnosis, diagnostic group, years off therapy, fractional shortening (FS), heart rate, and smoking status were found to be independently predictive of self‐reported health. Interaction between female sex and higher low‐density lipoprotein values and between diagnosis and abnormal FS variably predicted low reported vitality and low reported modified New York Heart Association (NYHA) scores. Echocardiographic findings, cardiac risk factors, and treatment history explained 13% to 28% of the variance in perceived health and self‐reported modified NYHA scores.CONCLUSIONSSystolic function and cardiac risk factors were linked to lower self‐reported health and NYHA scores even in the absence of clinically evident cardiotoxicity. Cancer 2008. ©2008 American Cancer Society.

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“…26 Plasma homocysteine levels are higher with cyclosporine than tacrolimus. 27 This has been shown at 6 and 12 months after kidney transplant, and homocysteine values are closely related to serum creatinine in patients receiving cyclosporine or tacrolimus. 28 The endothelium controls coagulation, fibrinolysis, vascular tone, and immune response, and endothelial dysfunction may be caused by inflammation, retention of L-arginine inhibitors, oxidative stress, hyperhomocysteinemia, dyslipidemia, hyperglycemia, and hypertension.…”

Section: Discussionmentioning

confidence: 92%

Untitled

Kahvecioğlu

Güllülü²,

Dirican³

2014

Exp Clin Transplant

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Objectives: Cardiovascular disease is a common cause of morbidity and mortality in patients with chronic kidney failure, before and after a kidney transplant. Oxidation of lipoproteins that contain apolipoprotein B may contribute to the initiation of atherosclerosis. Paraoxonase may prevent cardiovascular disease. We compared the effects of different calcineurin inhibitors on risk factors for cardiovascular disease in kidney transplant recipients. Materials and Methods: In 16 kidney transplant recipients, treatment included tacrolimus in 8 patients and cyclosporine in 8 patients. Hemoglobin, glucose, renal function, lipid parameters, high-sensitivity C-reactive protein, homocysteine, malondialdehyde, paraoxonase activity, and arylesterase activity were measured before transplant and at 1, 6, and 12 months after the transplant. Results: The levels of homocysteine and malondialdehyde did not change significantly in patients who received either tacrolimus or cyclosporine. The high-sensitivity C-reactive protein was decreased (tacrolimus group, 1 mo) and increased (cyclosporine group, 6 and 12 mo) after the kidney transplant. Paraoxonase activity was increased (tacrolimus group, 1 mo). Arylesterase activity was increased (tacrolimus group, 1, 6, and 12 mo; cyclosporine group, 1 and 6 mo). The percentage of change in arylesterase activity was higher at 12 months in the tacrolimus than in the cyclosporine group. Conclusions: Tacrolimus may be more effective than cyclosporine in improving risk factors for cardiovascular disease after kidney transplant.

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Risk Factors for Cardiovascular Disease in Children and Young Adults after Renal Transplantation

Cited by 49 publications

References 41 publications

Efeitos negativos da insuficiência renal crônica sobre a função pulmonar e a capacidade funcional

Efeitos negativos da insuficiência renal crônica sobre a função pulmonar e a capacidade funcional

Subclinical late cardiac toxicity in childhood cancer survivors

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