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Cardiovascular disease after renal transplantation.

B L Kasiske, C Guijarro, Z A Massy, M R Wiederkehr and J Z Ma
JASN January 1996, 7 (1) 158-165; DOI: https://doi.org/10.1681/ASN.V71158
B L Kasiske
Department of Medicine, University of Minnesota College of Medicine, Minneapolis 55415, USA.
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C Guijarro
Department of Medicine, University of Minnesota College of Medicine, Minneapolis 55415, USA.
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Z A Massy
Department of Medicine, University of Minnesota College of Medicine, Minneapolis 55415, USA.
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M R Wiederkehr
Department of Medicine, University of Minnesota College of Medicine, Minneapolis 55415, USA.
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J Z Ma
Department of Medicine, University of Minnesota College of Medicine, Minneapolis 55415, USA.
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Abstract

Although cardiovascular disease is a major cause of morbidity and mortality after renal transplantation, its pathogenesis and treatment are poorly understood. We conducted separate analyses of risk factors for ischemic heart disease, cerebral, and peripheral vascular disease after 706 renal transplants, all of which functioned for at least 6 months. We used Cox proportional hazards analysis to examine the effects of multiple pretransplant and posttransplant risk factors and included time-dependent variables measured at 3, 6, and 12 months, and annually to last follow-up at 7.0 +/- 4.2 yr. The independent relative risk (RR) of diabetes was 3.25 for ischemic heart disease, 3.21 for cerebral vascular disease, and 28.18 peripheral vascular disease (P < 0.05). The RR of each acute rejection episode was 1.40 for ischemic heart disease and 1.24 for cerebral vascular disease. Among serum lipid levels, high-density lipoprotein cholesterol was the best predictor of ischemic heart disease (RR = 0.80 for each 10 mg/dL). Posttransplant ischemic heart disease was strongly predictive of cerebral (5.80) and peripheral vascular disease (5.22), whereas ischemic heart disease was predicted by posttransplant cerebral (8.25) and peripheral vascular disease (4.58). Other risk factors for vascular disease included age, gender, cigarette smoking, pretransplant splenectomy, and serum albumin. Hypertension and low-density lipoprotein cholesterol had no effect, perhaps because of aggressive pharmacologic treatment. Thus, the incidence of cardiovascular disease continues to be high after renal transplantation, and multiple risk factors suggest a number of possible strategies for more effective treatment and prevention.

  • Copyright © 1996 by American Society of Nephrology
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Journal of the American Society of Nephrology
Vol. 7, Issue 1
1 Jan 1996
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Cardiovascular disease after renal transplantation.
B L Kasiske, C Guijarro, Z A Massy, M R Wiederkehr, J Z Ma
JASN Jan 1996, 7 (1) 158-165; DOI: 10.1681/ASN.V71158

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Cardiovascular disease after renal transplantation.
B L Kasiske, C Guijarro, Z A Massy, M R Wiederkehr, J Z Ma
JASN Jan 1996, 7 (1) 158-165; DOI: 10.1681/ASN.V71158
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Cited By...

  • New Onset Diabetes Mellitus after Transplant: The Challenge Continues
  • Pre-Renal Transplant Risk Stratification: A Perpetual Quandary
  • Interferon-{gamma}-Mediated Allograft Rejection Exacerbates Cardiovascular Disease of Hyperlipidemic Murine Transplant Recipients
  • A Longitudinal Study of Inflammation, CKD-Mineral Bone Disorder, and Carotid Atherosclerosis after Renal Transplantation
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  • Variations in the Risk for Cerebrovascular Events after Kidney Transplant Compared with Experience on the Waiting List and after Graft Failure
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  • Early Posttransplant Serum Osteoprotegerin Levels Predict Long-Term (8-Year) Patient Survival and Cardiovascular Death in Renal Transplant Patients
  • Incidence and Predictors of Myocardial Infarction after Kidney Transplantation
  • New-Onset Diabetes After Transplantation 2003 International Consensus Guidelines: An endocrinologist's view
  • Coronary Angiography Is the Best Predictor of Events in Renal Transplant Candidates Compared With Noninvasive Testing
  • CD4 Cell Lymphopenia and Atherosclerosis in Renal Transplant Recipients
  • Kidney Transplantation in the Elderly: A Decision Analysis
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  • Sympathetic Nerve Activity in End-Stage Renal Disease
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  • Lower-Extremity Peripheral Arterial Disease among Patients with End-Stage Renal Disease
  • Long-Term Results of a Randomized Study Comparing Three Immunosuppressive Schedules with Cyclosporine in Cadaveric Kidney Transplantation
  • Recommendations for the Outpatient Surveillance of Renal Transplant Recipients
  • Coronary Heart Disease in Chronic Renal Insufficiency: Some Management Considerations
  • Explained and Unexplained Ischemic Heart Disease Risk after Renal Transplantation
  • Abnormalities of endothelial function in patients with predialysis renal failure
  • Homocysteine: "Expensive Creatinine" or Important, Modifiable Risk Factor for Arteriosclerotic Outcomes in Renal Transplant Recipients?
  • Serum Total Homocysteine and Cardiovascular Disease Occurrence in Chronic, Stable Renal Transplant Recipients: A Prospective Study
  • Enhanced Reduction of Fasting Total Homocysteine Levels With Supraphysiological Versus Standard Multivitamin Dose Folic Acid Supplementation in Renal Transplant Recipients
  • Identification of Risk Factors in Hypertensive Patients : Contribution of Randomized Controlled Trials Through an Individual Patient Database
  • The Clinical Epidemiology of Cardiac Disease in Chronic Renal Failure
  • Body Composition in Renal Transplant Patients: Bioimpedance Analysis Compared to Isotope Dilution, Dual Energy X-Ray Absorptiometry, and Anthropometry
  • Hyperhomocysteinemia in Chronic Renal Disease
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  • Elevated Fasting Total Plasma Homocysteine Levels and Cardiovascular Disease Outcomes in Maintenance Dialysis Patients : A Prospective Study
  • Excess Prevalence of Fasting and Postmethionine-Loading Hyperhomocysteinemia in Stable Renal Transplant Recipients
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