Discussion on the risk factors of developing cardiovascular diseases (CVD) after the kidney transplantation.

ABSTRACT

To discuss the risk factors of developing cardiovascular disease (CVD) after the kidney transplantation. Retrospective analysis on the data of 1106 patients who had been underwent kidney allotransplantation in People's Hospital of Zhengzhou from July, 2010 to Dec, 2014 and conformed to the inclusion criteria was taken. Cox proportional hazard model was used to analyze the risk factors of developing CVD after the kidney transplantation. 7 days, 1 month, 3 months, 6 months and 12 months before and after the operation, the data collection and following-up visits were respectively arranged. 12 months after the operation, the following-up visits were arranged once a half year until the end of March, 2014. 216 (19.5%) patients developed CVD after the kidney transplantation. Among them, 47 (4.2%) patients developed CVD within the first three months after the operation, which accounted for 26.8% in the CVD patients; 125 (11.3%) patients developed CVD within the first one year after the operation, which accounted for 47.9% in the CVD patients. 51 (4.6%) patients died after the operation. Among them, 19 (2.7%) patients died of CVD, which accounted for 37.3% in the whole died patients. Multiple factors analysis revealed that the following were the risk factors to develop CVD after the kidney transplantation The age of receptors was greater than 50 (OR=2.39, 95%CI 1.15-3.60); The receptors had diabetes before the surgery (OR=3.18, 95%CI 1.56-6.42); The receptors had CVD medical history before the surgery (OR=3.85, 95%CI 2.15-7.54); The primary diseases of receptors were diabetic nephropathy (DN) (OR=2.12, 95%CI 1.14-3.98); The preoperative dialysis time was greater than 12 months(OR=1.27, 95%CI 0.98-1.38); The postoperative serum creatinine of the receptors was greater than 200 µmol/L (OR=2.78, 95%CI 1.35~4.53); The delayed graft failure (DGF) occurred (OR=1.24, 95%CI 1.02~1.42); Acute rejection appeared(AR)(OR=2.98, 95%CI 1.56~5.72); Renal allograft dysfunction appeared (OR=4.86, 95%CI 3.15~7.78). The morbidity of CVD is high after the kidney transplantation and the risk factors are diversified. That revising or excluding relevant risk factors may lower the morbidity of developing CVD and is in favor of the long-term survival for the transplanted kidney.