#6857 MATHEMATICAL MODEL FOR ADVERSE CARDIOVASCULAR EVENTS RISK ASSESSMENT IN KIDNEY TRANSPLANT RECIPIENTS

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Abstract Background and Aims Kidney transplantation is the most cardioprotective method of renal replacement therapy. Nevertheless, cardiovascular diseases are one of the main reason of mortality of with functioning kidney graft. The aim is creation of a mathematical model for adverse cardiovascular events risk assessment in kidney transplant recipients (KTR). Method The study included 237 kidney transplant recipients whose age was 47.1±10.8 years. For three years of observation 79 (33.3%) patients had adverse cardiovascular events (CVE) (acute coronary syndrome, life-threatening rhythm disturbance, complicated hypertensive crisis). The comparison group was 158 (66.7%) recipients without cardiovascular events. The study groups were comparable by gender, age and traditional cardiovascular risk factors. Results The proportion of patients with obesity and the graft glomerular filtration rate less than 30 ml/min/1.73 m2 were higher in KTR with CVE than in KTR without CVE –– 27.8% (n = 22) versus 12.7% (n = 20) and 12.7% (n = 10) versus 3.2% (n = 5), p<0.01. p<0.01. The erythrocytosis and an increased NT-proBNP blood level was more common in KTR with CVE than in KTR without CVE – 29.1% (n = 23) versus 16.5% (n = 26), p<0.05 and 27.8% (n = 22) versus 11.4% (n = 18), p<0.01. KTR with CVE had a longer duration of chronic kidney disease than KTR without CVE – 21.1±12.2 years versus 16.6±9.6 years, p<0.01. Triglycerides and low density lipoproteins blood levels of KTR with CVE were higher than those of KTR without CVE – 1.70 (1.30-2.50) mmol/L versus 1.45 (1.08-1.80) and 2.97±0.88 mmol/L versus 2.61±0.69 mmol/L, p<0.01, respectively. was more common in KTR with CVE than in KTR without CVE. The above factors were included in the mathematical model. $Y\; = \;\frac{1}{{\;1 + {e^{( {4,156 - 1,033X1 - 0,037X2 - 1,003X3 - 0,384X4 - 0,470X5 - 1,712X6 - 1,119X7} )}}}},$ X1 - body mass index > 30 kg/m2 (0 - no, 1 - yes), X2 - duration of chronic kidney disease (years); X3 - erythrocytosis (0 - no, 1 - yes), X4 - triglycerides blood level (mmol/l); X5 - low density lipoproteins blood level (mmol/l); X6 - glomerular filtration less than 30 ml/min/1.73 m2 (0 - no, 1 - yes), X7 - increased NT-proBNP blood level (0 - no, 1 - yes) The formula predicts low risk of CVE in kidney transplant recipients with an estimated value of Y<0.35, with Y≥0.35 - high risk. Conclusion Obesity, graft dysfunction erythrocytosis, an elevated NT-proBNP blood level, longer duration of chronic kidney disease, higher triglycerides and low density lipoproteins blood levels can be used to assess cardiovascular risk in kidney transplant recipients.