Cardiovascular morbidity and mortality after kidney transplantation

被引:173
作者
Stoumpos, Sokratis [1 ]
Jardine, Alan G. [1 ,2 ]
Mark, Patrick B. [1 ,2 ]
机构
[1] Univ Glasgow, Western Infirm, Glasgow Renal & Transplant Unit, Glasgow G11 6NT, Lanark, Scotland
[2] Univ Glasgow, Inst Cardiovasc & Med Sci, BHF Glasgow Cardiovasc Res Ctr, Glasgow G12 8TA, Lanark, Scotland
关键词
arrhythmia; atherosclerosis; cardiovascular; hypertension; kidney transplant; lipids; statins; LEFT-VENTRICULAR HYPERTROPHY; CONGESTIVE-HEART-FAILURE; CALCINEURIN INHIBITOR WITHDRAWAL; POSTTRANSPLANT DIABETES-MELLITUS; VASCULAR OUTCOME REDUCTION; INDEPENDENT RISK-FACTOR; BLOOD-PRESSURE CONTROL; RENAL GRAFT FUNCTION; LONG-TERM OUTCOMES; DIALYSIS PATIENTS;
D O I
10.1111/tri.12413
中图分类号
R61 [外科手术学];
学科分类号
摘要
Kidney transplantation is the optimal treatment for patients with end stage renal disease (ESRD) who would otherwise require dialysis. Patients with ESRD are at dramatically increased cardiovascular (CV) risk compared with the general population. As well as improving quality of life, successful transplantation accords major benefits by reducing CV risk in these patients. Worldwide, cardiovascular disease remains the leading cause of death with a functioning graft and therefore is a leading cause of graft failure. This review focuses on the mechanisms underpinning excess CV morbidity and mortality and current evidence for improving CV risk in kidney transplant recipients. Conventional CV risk factors such as hypertension, diabetes mellitus, dyslipidaemia and pre-existing ischaemic heart disease are all highly prevalent in this group. In addition, kidney transplant recipients exhibit a number of risk factors associated with pre-existing renal disease. Furthermore, complications specific to transplantation may ensue including reduced graft function, side effects of immunosuppression and post-transplantation diabetes mellitus. Strategies to improve CV outcomes post-transplantation may include pharmacological intervention including lipid-lowering or antihypertensive therapy, optimization of graft function, lifestyle intervention and personalizing immunosuppression to the individual patients risk profile.
引用
收藏
页码:10 / 21
页数:12
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