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Cardiovascular diseases and risk factors in kidney transplant candidates

Year 2021, Volume 7, Issue 5, 524 - 532, 04.09.2021
https://doi.org/10.18621/eurj.903376

Abstract

Objectives: Cardiovascular diseases and risk factors are associated with adverse cardiac events following kidney transplant. Therefore, pre-transplant evaluation of cardiovascular diseases and risk factors is important for determining the cardiac risk. The objective of this study is to determine the prevalence of cardiovascular diseases and risk factors in kidney transplant candidates.

Methods: This is a single-center and observational study which includes 174 end-stage renal disease patients (male: 55.2% and mean age: 49 ± 13 years) who underwent kidney transplant. Preoperative clinical characteristics, cardiovascular diseases and risk factors of the patients were examined retrospectively.

Results: The study population had multiple cardiovascular risk factors such as hypertension (66.7%), diabetes (28.2%), dyslipidemia (29.9%) and smoking (30.5%) in the evaluation conducted prior to kidney transplant. The most common cardiovascular diseases were detected as congestive heart failure (10.9%) and coronary artery disease (8.6%). The rate of the patients who underwent myocardial revascularization (percutaneous coronary intervention or coronary artery bypass grafting) before kidney transplant was 6.9%. The patients’ mean left ventricular mass index was 114 ± 32 g/m2, and 55.5% of the study population had left ventricular hypertrophy.

Conclusions: In our study, the prevalence of cardiovascular diseases and risk factors in the patients who underwent kidney transplant was found to be high.

References

  • 1. Jardine A, Gaston R, Fellstrom B, Holdaas H. Prevention of cardiovascular disease in adult recipients of kidney transplants. Lancet 2011;378:1419-27.
  • 2. Soveri I, Holme I, Holdaas H, Budde K, Jardine AG, Fellström B. A cardiovascular risk calculator for renal transplant recipients. Transplantation 2012;94:57-62.
  • 3. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998;32:S112-9.
  • 4. Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 1999;341:1725-30.
  • 5. Pilmore H, Dent H, Chang S, McDonald SP, Chadban SJ. Reduction in cardiovascular death after kidney transplantation. Transplantation 2010;89:851-7.
  • 6. Lentine KL, Costa SP, Weir MR, Robb JF, Fleisher LA, Kasiske BL, et al.; Cardiac disease evaluation and management among kidney and liver transplantation candidates: a scientific statement from the American Heart Association and the American College of Cardiology Foundation: endorsed by the American Society of Transplant Surgeons, American Society of Transplantation, and National Kidney Foundation. Circulation 2012;126:617-63.
  • 7. Kasiske BL, Zeier MG, Chapman JR, Craig JC, Ekberg H, Garvey CA, et al; Kidney Disease: Improving Global Outcomes. KDIGO clinical practice guideline for the care of kidney transplant recipients: a summary. Kidney Int 2010;77:299-311.
  • 8. Aalten J, Hoogeveen EK, Roodnat JI, Weimar W, Borm GF, de Fijter JW, et al. Associations between pre-kidney-transplant risk factors and post-transplant cardiovascular events and death. Transpl Int 2008;21:985-91.
  • 9. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013;34:2159-219.
  • 10. Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al.; ESC Scientific Document Group. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 2020;41:255-323.
  • 11. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al.; ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 2020;41:111-88.
  • 12. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al.; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 2020;41:407-77.
  • 13. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al.; ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016;37:2129-200.
  • 14. Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 1986;57:450-8.
  • 15. Aalten J, Hoogeveen EK, Roodnat JI, Weimar W, Borm GF, de Fijter JW, et al. Associations between pre-kidney-transplant risk factors and post-transplant cardiovascular events and death. Transpl Int 2008;21:985-91.
  • 16. Vanrenterghem YF, Claes K, Montagnino G, Fieuws S, Maes B, Villa M, et al. Risk factors for cardiovascular events after successful renal transplantation. Transplantation 2008;85:209-16.
  • 17. Goyal A, Chatterjee K, Mathew RO, Sidhu MS, Bangalore S, McCullough PA, et al. In-Hospital Mortality and Major Adverse Cardiovascular Events after Kidney Transplantation in the United States. Cardiorenal Med 2019;9:51-60.
  • 18. Fazelzadeh A, Mehdizadeh A, Ostovan MA, Raiss-Jalali GA. Incidence of cardiovascular risk factors and complications before and after kidney transplantation. Transplant Proc 2006;38:506-8.
  • 19. Gonçalves M, Vieira P, Resende L, Durães J, Rosa N, Teixeira JA, et al. Metabolic profile and cardiovascular risk in a population of renal transplant recipients. Transplant Proc 2015;47:985-8.
  • 20. Rigatto C, Parfrey P, Foley R, Negrijn C, Tribula C, Jeffery J. Congestive heart failure in renal transplant recipients: risk factors, outcomes, and relationship with ischemic heart disease. J Am Soc Nephrol 2002;13:1084-90.
  • 21. Abbott KC, Bucci JR, Cruess D, Taylor AJ, Agodoa LY. Graft loss and acute coronary syndromes after renal transplantation in the United States. J Am Soc Nephrol 2002;13:2560-9.
  • 22. Seoane-Pillado MT, Pita-Fernández S, Valdés-Cañedo F, Seijo-Bestilleiro R, Pértega-Díaz S, Fernández-Rivera C, et al. Incidence of cardiovascular events and associated risk factors in kidney transplant patients: a competing risks survival analysis. BMC Cardiovasc Disord 2017;17:72.
  • 23. Chuang P, Gibney EM, Chan L, Ho PM, Parikh CR. Predictors of cardiovascular events and associated mortality within two years of kidney transplantation. Transplant Proc 2004;36:1387-91.
  • 24. Díaz JM, Gich I, Bonfill X, Solà R, Guirado L, Facundo C, et al. Prevalence evolution and impact of cardiovascular risk factors on allograft and renal transplant patient survival. Transplant Proc 2009;41:2151-5.
  • 25. Ojo AO. Cardiovascular complications after renal transplantation and their prevention. Transplantation 2006;82:603-11.
  • 26. Timmis A, Townsend N, Gale CP, Torbica A, Lettino M, Petersen SE, et al.; European Society of Cardiology. European Society of Cardiology: Cardiovascular Disease Statistics 2019. Eur Heart J 2020;41:12-85.
  • 27. Noshad H, Ardalan MR, Mortazavi M, Tayebi H, Safa J, Nezami N. Kidney transplantation candidates and cardiovascular risk factors. Transplant Proc 2007;39:871-4.

Year 2021, Volume 7, Issue 5, 524 - 532, 04.09.2021
https://doi.org/10.18621/eurj.903376

Abstract

References

  • 1. Jardine A, Gaston R, Fellstrom B, Holdaas H. Prevention of cardiovascular disease in adult recipients of kidney transplants. Lancet 2011;378:1419-27.
  • 2. Soveri I, Holme I, Holdaas H, Budde K, Jardine AG, Fellström B. A cardiovascular risk calculator for renal transplant recipients. Transplantation 2012;94:57-62.
  • 3. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998;32:S112-9.
  • 4. Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 1999;341:1725-30.
  • 5. Pilmore H, Dent H, Chang S, McDonald SP, Chadban SJ. Reduction in cardiovascular death after kidney transplantation. Transplantation 2010;89:851-7.
  • 6. Lentine KL, Costa SP, Weir MR, Robb JF, Fleisher LA, Kasiske BL, et al.; Cardiac disease evaluation and management among kidney and liver transplantation candidates: a scientific statement from the American Heart Association and the American College of Cardiology Foundation: endorsed by the American Society of Transplant Surgeons, American Society of Transplantation, and National Kidney Foundation. Circulation 2012;126:617-63.
  • 7. Kasiske BL, Zeier MG, Chapman JR, Craig JC, Ekberg H, Garvey CA, et al; Kidney Disease: Improving Global Outcomes. KDIGO clinical practice guideline for the care of kidney transplant recipients: a summary. Kidney Int 2010;77:299-311.
  • 8. Aalten J, Hoogeveen EK, Roodnat JI, Weimar W, Borm GF, de Fijter JW, et al. Associations between pre-kidney-transplant risk factors and post-transplant cardiovascular events and death. Transpl Int 2008;21:985-91.
  • 9. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013;34:2159-219.
  • 10. Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al.; ESC Scientific Document Group. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 2020;41:255-323.
  • 11. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al.; ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 2020;41:111-88.
  • 12. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al.; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 2020;41:407-77.
  • 13. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al.; ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016;37:2129-200.
  • 14. Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 1986;57:450-8.
  • 15. Aalten J, Hoogeveen EK, Roodnat JI, Weimar W, Borm GF, de Fijter JW, et al. Associations between pre-kidney-transplant risk factors and post-transplant cardiovascular events and death. Transpl Int 2008;21:985-91.
  • 16. Vanrenterghem YF, Claes K, Montagnino G, Fieuws S, Maes B, Villa M, et al. Risk factors for cardiovascular events after successful renal transplantation. Transplantation 2008;85:209-16.
  • 17. Goyal A, Chatterjee K, Mathew RO, Sidhu MS, Bangalore S, McCullough PA, et al. In-Hospital Mortality and Major Adverse Cardiovascular Events after Kidney Transplantation in the United States. Cardiorenal Med 2019;9:51-60.
  • 18. Fazelzadeh A, Mehdizadeh A, Ostovan MA, Raiss-Jalali GA. Incidence of cardiovascular risk factors and complications before and after kidney transplantation. Transplant Proc 2006;38:506-8.
  • 19. Gonçalves M, Vieira P, Resende L, Durães J, Rosa N, Teixeira JA, et al. Metabolic profile and cardiovascular risk in a population of renal transplant recipients. Transplant Proc 2015;47:985-8.
  • 20. Rigatto C, Parfrey P, Foley R, Negrijn C, Tribula C, Jeffery J. Congestive heart failure in renal transplant recipients: risk factors, outcomes, and relationship with ischemic heart disease. J Am Soc Nephrol 2002;13:1084-90.
  • 21. Abbott KC, Bucci JR, Cruess D, Taylor AJ, Agodoa LY. Graft loss and acute coronary syndromes after renal transplantation in the United States. J Am Soc Nephrol 2002;13:2560-9.
  • 22. Seoane-Pillado MT, Pita-Fernández S, Valdés-Cañedo F, Seijo-Bestilleiro R, Pértega-Díaz S, Fernández-Rivera C, et al. Incidence of cardiovascular events and associated risk factors in kidney transplant patients: a competing risks survival analysis. BMC Cardiovasc Disord 2017;17:72.
  • 23. Chuang P, Gibney EM, Chan L, Ho PM, Parikh CR. Predictors of cardiovascular events and associated mortality within two years of kidney transplantation. Transplant Proc 2004;36:1387-91.
  • 24. Díaz JM, Gich I, Bonfill X, Solà R, Guirado L, Facundo C, et al. Prevalence evolution and impact of cardiovascular risk factors on allograft and renal transplant patient survival. Transplant Proc 2009;41:2151-5.
  • 25. Ojo AO. Cardiovascular complications after renal transplantation and their prevention. Transplantation 2006;82:603-11.
  • 26. Timmis A, Townsend N, Gale CP, Torbica A, Lettino M, Petersen SE, et al.; European Society of Cardiology. European Society of Cardiology: Cardiovascular Disease Statistics 2019. Eur Heart J 2020;41:12-85.
  • 27. Noshad H, Ardalan MR, Mortazavi M, Tayebi H, Safa J, Nezami N. Kidney transplantation candidates and cardiovascular risk factors. Transplant Proc 2007;39:871-4.

Details

Primary Language English
Subjects Cardiac and Cardiovascular Systems
Journal Section Original Articles
Authors

Umut KOCABAŞ (Primary Author)
Department of Cardiology, Başkent University İzmir Hospital, İzmir, Turkey
0000-0001-6424-9399
Türkiye

Supporting Institution Başkent University School of Medicine
Project Number KA20/100
Publication Date September 4, 2021
Application Date March 25, 2021
Acceptance Date June 8, 2021
Published in Issue Year 2021, Volume 7, Issue 5

Cite

EndNote %0 The European Research Journal Cardiovascular diseases and risk factors in kidney transplant candidates %A Umut Kocabaş %T Cardiovascular diseases and risk factors in kidney transplant candidates %D 2021 %J The European Research Journal %P -2149-3189 %V 7 %N 5 %R doi: 10.18621/eurj.903376 %U 10.18621/eurj.903376

e-ISSN: 2149-3189 


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