Abstract
Patients that undergo renal transplantation (RT) often suffer from high rates of cardiovascular disease-related mortality, yet, most of the studies focus on coronary angiography performed as screening to entry in a waiting list and not, as for clinical indication, after renal transplantation. This study examined coronary angiography findings from 45 patients with functional renal grafts for over 6 months that were analyzed in Anzhen Hospital (Beijing, China) from 2014-2019. For comparison purposes, we additionally examined coronary angiography findings from 45 age- and sex-matched patients undergoing chronic dialysis due to end-stage renal disease (ESRD). We used the SYNTAX score to gauge coronary artery disease (CAD) severity. The duration of ESRD in patients in the RT group was significantly longer than for that of patients in the dialysis comparison group (19.31 ± 7.83 years vs. 11.43 ± 8.04 years, p < 0.001). The SYNTAX scores for patients in the dialysis and RT groups were 17.76 ± 7.35 and 12.57 ± 5.61, respectively (p < 0.01). We found that 64.4% and 28.9% of dialysis and RT patients, respectively, exhibited the presence of moderate or severe calcified lesions upon examination. In addition, the SYNTAX scores of RT patients were correlated with ESRD duration (p < 0.001). We observed less serious CAD in RT patients relative to long-term dialysis patients even though the former group exhibited a longer mean ESRD duration. Both groups exhibited high rates of calcification of the coronary artery, even following RT.
Highlights
Individuals suffering from end-stage renal disease (ESRD) are at an elevated risk of prematurely developing cardiovascular disease (CVD) as a result of altered sodium or fluid homeostasis, atherosclerotic inflammation, and pronounced calcification [1]
renal transplantation (RT) patients typically exhibit a wide range of cardiovascular risk factors associated with the elevated rates of CVD in this patient population, including general risk factors and additional factors that are associated with the renal failure and transplantation process [6]
There were no differences in age and family history of CVD distributions between the dialysis and RT groups (Table 2)
Summary
Individuals suffering from end-stage renal disease (ESRD) are at an elevated risk of prematurely developing cardiovascular disease (CVD) as a result of altered sodium or fluid homeostasis, atherosclerotic inflammation, and pronounced calcification [1]. The rates of RT recipient survival have been steadily rising in recent years owing to advances in patient care and the development of increasingly reliable immunosuppressive drug regimens that can improve graft acceptance Despite these advances, cardiovascular complications remain the leading factor adversely impacting the postoperative survival of RT patients [4,5]. RT patients are likely to have an extensive history of risk factors including prolonged renal disease, prior transplant rejection, preexisting CVD, and history of dialysis, all of which can increase the risk of CAD development. Conclusions: We observed less serious CAD in RT patients relative to long-term dialysis patients even though the former group exhibited a longer mean ESRD duration Both groups exhibited high rates of calcification of the coronary artery, even following RT
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