Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies

Janani Rangaswami, Roy O. Mathew, Raviprasenna Parasuraman, Ekamol Tantisattamo, Michelle Lubetzky, Swati Rao, Muhammad Yaqub, Kelly A. Birdwell, William Bennett, Pranav Dalal, Rajan Kapoor, Edgar V. Lerma, Mark Lerman, Nicole McCormick, Sripal Bangalore, Peter A. McCullough, Darshana M. Dadhania

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Kidney transplantation (KT) is the optimal therapy for end-stage kidney disease (ESKD), resulting in significant improvement in survival as well as quality of life when compared with maintenance dialysis. The burden of cardiovascular disease (CVD) in ESKD is reduced after KT; however, it still remains the leading cause of premature patient and allograft loss, as well as a source of significant morbidity and healthcare costs. All major phenotypes of CVD including coronary artery disease, heart failure, valvular heart disease, arrhythmias and pulmonary hypertension are represented in the KT recipient population. Pre-existing risk factors for CVD in the KT recipient are amplified by superimposed cardio-metabolic derangements after transplantation such as the metabolic effects of immunosuppressive regimens, obesity, posttransplant diabetes, hypertension, dyslipidemia and allograft dysfunction. This review summarizes the major risk factors for CVD in KT recipients and describes the individual phenotypes of overt CVD in this population. It highlights gaps in the existing literature to emphasize the need for future studies in those areas and optimize cardiovascular outcomes after KT. Finally, it outlines the need for a joint 'cardio-nephrology' clinical care model to ensure continuity, multidisciplinary collaboration and implementation of best clinical practices toward reducing CVD after KT.

Original languageEnglish (US)
Pages (from-to)760-773
Number of pages14
JournalNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Volume34
Issue number5
DOIs
StatePublished - May 1 2019

Fingerprint

Kidney Transplantation
Epidemiology
Cardiovascular Diseases
Kidney
Chronic Kidney Failure
Allografts
Phenotype
Heart Valve Diseases
Nephrology
Immunosuppressive Agents
Dyslipidemias
Transplant Recipients
Practice Guidelines
Pulmonary Hypertension
Health Care Costs
Population
Cardiac Arrhythmias
Coronary Artery Disease
Dialysis
Heart Failure

Keywords

  • cardiovascular disease
  • chronic kidney disease
  • kidney transplantation
  • multidisciplinary management
  • risk factors

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Cardiovascular disease in the kidney transplant recipient : epidemiology, diagnosis and management strategies. / Rangaswami, Janani; Mathew, Roy O.; Parasuraman, Raviprasenna; Tantisattamo, Ekamol; Lubetzky, Michelle; Rao, Swati; Yaqub, Muhammad; Birdwell, Kelly A.; Bennett, William; Dalal, Pranav; Kapoor, Rajan; Lerma, Edgar V.; Lerman, Mark; McCormick, Nicole; Bangalore, Sripal; McCullough, Peter A.; Dadhania, Darshana M.

In: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, Vol. 34, No. 5, 01.05.2019, p. 760-773.

Research output: Contribution to journalArticle

Rangaswami, J, Mathew, RO, Parasuraman, R, Tantisattamo, E, Lubetzky, M, Rao, S, Yaqub, M, Birdwell, KA, Bennett, W, Dalal, P, Kapoor, R, Lerma, EV, Lerman, M, McCormick, N, Bangalore, S, McCullough, PA & Dadhania, DM 2019, 'Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies', Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, vol. 34, no. 5, pp. 760-773. https://doi.org/10.1093/ndt/gfz053
Rangaswami, Janani ; Mathew, Roy O. ; Parasuraman, Raviprasenna ; Tantisattamo, Ekamol ; Lubetzky, Michelle ; Rao, Swati ; Yaqub, Muhammad ; Birdwell, Kelly A. ; Bennett, William ; Dalal, Pranav ; Kapoor, Rajan ; Lerma, Edgar V. ; Lerman, Mark ; McCormick, Nicole ; Bangalore, Sripal ; McCullough, Peter A. ; Dadhania, Darshana M. / Cardiovascular disease in the kidney transplant recipient : epidemiology, diagnosis and management strategies. In: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 2019 ; Vol. 34, No. 5. pp. 760-773.
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