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Early cardiovascular events and cardiovascular death after renal transplantation: role of pretransplant risk factors

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Abstract

Background

The purpose of this study was to verify the risk factors present in patients on the kidney transplant waiting list that may interfere with the incidence of cardiovascular (CV) events and death during the first 12 months after transplantation.

Methods

Based on the data collected prospectively during pretransplant workups, a retrospective study was conducted including 665 patients followed up until death or completing 12 months posttransplantation. Endpoints were the composite incidence of CV events and death.

Results

The prevalence of diabetes, LV hypertrophy, and CV disease at baseline was high; 14% of patients had angina, 26% an abnormal myocardial scan, and 47% coronary artery disease. CV events occurred in 53 patients (8.4%) and in 29 (55%) caused death. The independent predictors of events were age ≥ 50 years (HR 2.292; CI% 1.093–4.806), angina (HR 1.969; CI% 1.039–3.732), and altered myocardial scan (HR 1.905, CI% 1.059–3.428). Altered myocardial scan (HR 2.822, 95% CI 1.095–6.660) was also one of the independent predictor of CV death.

Conclusion

The incidence of CV events and death were predicted by variables associated with myocardial ischemia, a potentially modifiable risk factor. Patients with pretransplantation myocardial ischemia should be considered at a higher risk of developing early CV complications and managed accordingly before, during, and after kidney transplantation.

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Data availability

Raw data are available for further analysis.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Heart Institute (InCor), Hospital das Clínicas, University of São Paulo Medical School, Rua Eneas Carvalho Aguiar 44, São Paulo, SP, 05403-000, Brazil

    Jose Jayme G. De Lima, Luis Henrique W. Gowdak & Luiz A. Bortolotto

  2. Renal Transplant Unit, Urology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil

    Elias David-Neto

Authors
  1. Jose Jayme G. De Lima
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  2. Luis Henrique W. Gowdak
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  3. Elias David-Neto
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  4. Luiz A. Bortolotto
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Contributions

JJGDL, LHWG: participated in research design, participated in the writing of the paper, participated in the performance of the research and participated in data analysis. ED, LAB: participated in data analysis, participated in research design and participated in drafting the manuscript. All authors contributed to the study conception and design.

Corresponding author

Correspondence to Jose Jayme G. De Lima.

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The authors declare that they have no conflicts of interest.

Ethics approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number 3428/10/17) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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De Lima, J.J.G., Gowdak, L.H.W., David-Neto, E. et al. Early cardiovascular events and cardiovascular death after renal transplantation: role of pretransplant risk factors. Clin Exp Nephrol 25, 545–553 (2021). https://doi.org/10.1007/s10157-021-02019-6

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  • DOI: https://doi.org/10.1007/s10157-021-02019-6

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