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Renal transplant dysfunction—importance quantified in comparison with traditional risk factors for cardiovascular disease and mortality

Soveri, Inga ; Holdaas, Hallvard ; Jardine, Alan ; Gimpelewicz, Claudio ; Staffler, Beatrix ; Fellström, Bengt

In: Nephrology Dialysis Transplantation, 2006, vol. 21, no. 8, p. 2282-2289

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    Titre
    • Renal transplant dysfunction—importance quantified in comparison with traditional risk factors for cardiovascular disease and mortality
    Auteur
    • Soveri, Inga. Department of Medical Sciences, Uppsala University, Uppsala, Sweden
    • Holdaas, Hallvard. Rikshospitalet, Oslo, Norway
    • Jardine, Alan. University of Glasgow, Glasgow, UK and
    • Gimpelewicz, Claudio. NOVARTIS, Basel, Switzerland
    • Staffler, Beatrix. NOVARTIS, Basel, Switzerland
    • Fellström, Bengt. Department of Medical Sciences, Uppsala University, Uppsala, Sweden
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Nephrology Dialysis Transplantation, 2006, vol. 21, no. 8, p. 2282-2289. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:300521
    Summary
    Background. Renal transplant recipients (RTR) mainly die of premature cardiovascular disease. Traditional cardiovascular disease risk factors are prevalent in RTR. Additionally, non-traditional risk factors seem to contribute to the high risk. The impact of renal dysfunction was compared with traditional risk factors for cardiovascular morbidity and mortality in 1052 placebo-treated patients of the ALERT trial. Methods. All patients were on cyclosporine-based immunosuppressive therapy, follow-up was 5-6 years and captured endpoints included cardiac death, non-cardiovascular death, all-cause mortality, major adverse cardiac event (MACE), non-fatal myocardial infarction (MI) and stroke. Results. A calculated 84 µmol/l increase in serum creatinine was needed to double the risk for cardiac death, an increase of 104 µmol/l to double the risk for non-cardiovascular death and an increase of 92 µmol/l to double the risk for all-cause mortality. MACE risk was doubled if serum creatinine was elevated by 141 µmol/l, age was increased by 23 years, or LDL-cholesterol by 2 mmol/l. Diabetes increased the incidences of cardiac death, all-cause mortality, MACE, stroke and non-fatal MI. A serum creatinine increase of ∼130 µmol/l, or ∼20 years increase in age was calculated as similar in risk for cardiac death, all-cause mortality and MACE, and comparable to risk of diabetes in RTR. Conclusion. An increase in serum creatinine of 80-100 µmol/l doubles the risk for cardiac death, non-cardiovascular death and all-cause mortality in RTR. An increase of 130 µmol/l in serum creatinine or ∼20 years increase in age is comparable to risk of diabetes