Traditional and nontraditional cardiovascular risk factors and estimated risk for coronary artery disease in renal transplant recipients: a single-center experience

Nephron Clin Pract. 2011;119(3):c227-35. doi: 10.1159/000327616. Epub 2011 Aug 18.

Abstract

Background/aims: The prevalence of cardiovascular disease in renal transplant recipients is markedly higher than in the general population due to the high prevalence of traditional cardiovascular risk factors, renal transplant function impairment and treatment with immunosuppressive drugs that affect blood pressure, cholesterol and blood glucose levels.

Methods: Cross-sectional analysis using our renal transplant clinic cohort investigating (1) the cardiovascular risk factors present in this cohort, and (2) estimating their impact on the risk of coronary artery disease (CAD) by using the Framingham algorithm.

Results: Control of modifiable cardiovascular risk factors in 231 renal transplant recipients is suboptimal, i.e. 47.2% of patients are hypertensive, 10.3% actively smoke, 39.4% have serum cholesterol concentrations >200 mg/dl, and 19.7% have diabetes mellitus. Blood pressure, age, hyperlipidemia, smoking and diabetes modulate the estimated CAD risk in males and females. Furthermore, a short time period (less than 1 year) since transplantation and increased serum creatinine levels negatively influenced the CAD risk in this patient population.

Conclusion: According to current guidelines, the control of modifiable cardiovascular risk factors in renal transplant recipients is suboptimal. The decreasing CAD risk over time after transplantation may be due to the reduction of immunosuppressive drugs with time and survival bias.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Bias
  • Blood Pressure
  • Cholesterol / blood
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / etiology
  • Creatinine / blood
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology*
  • Female
  • Humans
  • Hypercholesterolemia / epidemiology*
  • Hypertension / drug therapy
  • Hypertension / epidemiology*
  • Immunosuppressive Agents / adverse effects
  • Kidney Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Renal Dialysis
  • Risk Factors
  • Smoking / adverse effects
  • Time Factors

Substances

  • Antihypertensive Agents
  • Immunosuppressive Agents
  • Cholesterol
  • Creatinine