The impact of living donor kidney transplantation on markers of cardiovascular risk in chronic kidney disease patients

Abstract

Background: Kidney transplant (Tx) patients present a reduced cardiovascular (CV) mortality in comparison to the dialysis population, but in comparison to the general population, it is still several-fold higher.

Methods: We studied risk factors for CV disease in a group of 38 patients (50% males, median age 36 years) who underwent a living donor Tx at the baseline and after 3 +/- 1 and 9 +/- 2 months.

Results: The prevalence of overweight increased from 26 to 54% after Tx (p < 0.001). The mean systolic blood pressure decreased significantly after the Tx (148 +/- 27.6 vs. 126 +/- 12.7 mm Hg). There was a significant increase in LDL (97 +/- 30 vs. 114 +/- 35) and hematocrit (33.8 +/- 4.4 to 42 +/- 5.7%) levels and a significant reduction in fibrinogen levels (394 +/- 91 vs. 366 +/- 100 mg/dl) after 9 months as compared to the baseline. Obesity and dislipidemia were significantly correlated with inflammation. Significant changes in left ventricle mass index (293 +/- 116 vs. 241 +/- 96) were observed after the Tx. Patients with a low glomerular filtration rate (GFR) in the follow-up evaluation presented higher LDL (128 +/- 7 vs. 99 +/- 7 mg/dl; p < 0.05) and higher fibrinogen levels (399 +/- 21 vs. 332 +/- 22 mg/dl; p < 0.05) compared to patients with a high GFR.

Conclusion: Most of the risk factors analyzed (particularly the uremia-related) improved after the renal Tx, which could justify the positive impact of Tx on the development of CV disease. Inflammation and dyslipidemia were related to renal dysfunction after the Tx, suggesting that complete restoration of renal function may have an impact on reducing CV mortality in CKD patients treated with renal Tx.