2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Abbott, K. C. Articles by Agodoa, L. Y. C. Search for Related Content PubMed PubMed Citation Articles by Abbott, K. C. Articles by Agodoa, L. Y. C.

Early Renal Insufficiency and Hospitalized Heart Disease after Renal Transplantation in the Era of Modern Immunosuppression

Kevin C. Abbott^*, Christina M. Yuan^*, Allen J. Taylor, David F. Cruess and Lawrence Y. C. Agodoa

*Nephrology Service, Walter Reed Army Medical Center, Washington, DC, and Uniformed Services University of the Health Sciences, Bethesda, Maryland; Cardiology Service, Walter Reed Army Medical Center, Washington, DC; Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland; and National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.

Correspondence to Dr. Kevin C. Abbott, Nephrology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001. Phone: 202-782-6462/6463/6288; Fax: 202-782-0185;

ABSTRACT. Renal insufficiency has been identified as a risk factor for graft loss and death after renal transplantation but has not been consistently linked to early, nonfatal, hospitalized heart disease (HHD). With the United States Renal Data System database, 29,597 patients who received a kidney transplant between January 1, 1996, and July 31, 2000, with Medicare as the primary payer, and were monitored until December 31, 2000, were studied. Cox proportional-hazards regression models were used to calculate the association of recipient estimated GFR (eGFR) at 1 yr after renal transplantation, as determined with the Modification of Diet in Renal Disease formula, with hospitalization for treatment of acute coronary syndromes (ACS) (International Classification of Diseases, version 9, code 410.x or 411.x) or congestive heart failure (CHF) (code 428.x) 1 to 3 yr after renal transplantation. Rates of ACS and CHF were 2.2 and 4.9%, respectively, for patients with eGFR of <44.8 ml/min per 1.73 m², compared with 1.2 and 1.4% for patients with eGFR of >69.7 ml/min per 1.73 m². Reduced eGFR (<44.8 ml/min per 1.73 m², compared with >69.7 ml/min per 1.73 m²) at the end of the first 1 yr after transplantation was independently associated with increased risks of both ACS (adjusted hazard ratio, 2.16; 95% confidence interval, 1.39 to 3.35) and CHF (adjusted hazard ratio, 2.95; 95% confidence interval, 2.24 to 3.90). It was concluded that early renal insufficiency (approximately stage 3 chronic kidney disease) was associated with higher rates of HHD 1 to 3 yr after kidney transplantation. Preservation of renal function after renal transplantation may reduce the rates of HHD, and renal transplant recipients with reduced eGFR should be considered at high risk of developing cardiovascular disease. E-mail: kevin.abbott@na.amedd.army.mil

This article has been cited by other articles:

				K. L. Lentine, L. A. R. Rey, S. Kolli, G. Bacchi, M. A. Schnitzler, K. C. Abbott, H. Xiao, and D. C. Brennan Variations in the Risk for Cerebrovascular Events after Kidney Transplant Compared with Experience on the Waiting List and after Graft Failure Clin. J. Am. Soc. Nephrol., July 1, 2008; 3(4): 1090 - 1101. [Abstract] [Full Text] [PDF]

				K. L. Lentine, M. A. Schnitzler, D. C. Brennan, J. J. Snyder, P. J. Hauptman, K. C. Abbott, D. Axelrod, P. R. Salvalaggio, and B. Kasiske Cardiac Evaluation before Kidney Transplantation: A Practice Patterns Analysis in Medicare-insured Dialysis Patients Clin. J. Am. Soc. Nephrol., July 1, 2008; 3(4): 1115 - 1124. [Abstract] [Full Text] [PDF]

				R. Borrows, M. Loucaidou, G. Chusney, S. Borrows, J. V. Tromp, T. Cairns, M. Griffith, N. Hakim, A. McLean, A. Palmer, et al. Anaemia and congestive heart failure early post-renal transplantation Nephrol. Dial. Transplant., May 1, 2008; 23(5): 1728 - 1734. [Abstract] [Full Text] [PDF]

				K. L. Lentine, M. A. Schnitzler, K. C. Abbott, L. Li, H. Xiao, T. E. Burroughs, S. K. Takemoto, L. M. Willoughby, J. A. Gavard, and D. C. Brennan Incidence, Predictors, and Associated Outcomes of Atrial Fibrillation after Kidney Transplantation Clin. J. Am. Soc. Nephrol., March 1, 2006; 1(2): 288 - 296. [Abstract] [Full Text] [PDF]

				B. L. Kasiske, J. R. Maclean, and J. J. Snyder Acute Myocardial Infarction and Kidney Transplantation J. Am. Soc. Nephrol., March 1, 2006; 17(3): 900 - 907. [Abstract] [Full Text] [PDF]

				R. Vanholder, Z. Massy, A. Argiles, G. Spasovski, F. Verbeke, N. Lameire, and for the European Uremic Toxin Work Group (EUTox) Chronic kidney disease as cause of cardiovascular morbidity and mortality Nephrol. Dial. Transplant., June 1, 2005; 20(6): 1048 - 1056. [Abstract] [Full Text] [PDF]

				K. L. Lentine, D. C. Brennan, and M. A. Schnitzler Incidence and Predictors of Myocardial Infarction after Kidney Transplantation J. Am. Soc. Nephrol., February 1, 2005; 16(2): 496 - 506. [Abstract] [Full Text] [PDF]

				K. C. Abbott, F. C. Trespalacios, L. Y. Agodoa, A. J. Taylor, and G. L. Bakris {beta}-Blocker Use in Long-term Dialysis Patients: Association With Hospitalized Heart Failure and Mortality Arch Intern Med, December 13, 2004; 164(22): 2465 - 2471. [Abstract] [Full Text] [PDF]

				K. C. Abbott, K. L. Lentine, J. R. Bucci, L. Y. Agodoa, J. M. Koff, K. C. Holtzmuller, and M. A. Schnitzler Impact of Diabetes and Hepatitis after Kidney Transplantation on Patients Who Are Affected by Hepatitis C Virus J. Am. Soc. Nephrol., December 1, 2004; 15(12): 3166 - 3174. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673