(Transpl Int. 2008;21:985-991)

Diabetic nephropathy and CVD prior to renal transplantation are the most important predictors of post-transplant cardiovascular events, researchers in The Netherlands conclude.

Jeroen Aalten, of Radboud University Medical Center Nijmegen, and colleagues studied 2,187 adult patients who received a first kidney transplant between 1984 and 1997. The study population had a 40% cumulative incidence of post-transplant cardiovascular events.

The incidence was highest in the first three months following transplantation.  Pretransplant diabetic nephropathy and claudication were independently associated with a threefold and twofold increased risk of a cardiovascular event after transplantation. A pretransplant cardiac event or cerebrovascular accident were independently associated with 76% and 53% increased risk, respectively.

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“Early treatment of cardiovascular risk factors and pretransplant cardiovascular evaluation might improve transplantation outcome,” the authors concluded.