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Family History of Atherosclerosis Plays Role in Renal Allograft Outcome: Presented at ERA-EDTA

By Lynda Jackson

COPENHAGEN, DENMARK -- July 18, 2002 -- In renal transplant patients, atherosclerosis poses a serious threat to graft survival, reported researchers here July 17 at the XXXIX Congress of the European Renal Association, European Dialysis and Transplant Association (ERA-EDTA).

Renal transplant patients have a five fold increase in cardiovascular mortality post-transplant compared with age matched controls, and this is the single most important factor related to graft loss, Dr. F. Nurhan Ozdemir, from the University Faculty of Medicine, Ankara, Turkey, said during her presentation.

Investigators led by Dr. Ozdemir evaluated the influence of recipient family history of atherosclerosis, hypertension and diabetes mellitus, on the development of atherosclerotic events, posttransplant serum albumin levels and lipid profile, and progression of cardiovascular disorder and renal allograft dysfunction.

They reviewed the charts of 166 patients who received living related kidneys and 61 who received cadaveric kidneys, mean age 37±11.8 years, who had been followed for at least five years. Patients with pre-transplant atherosclerosis and those with diabetes mellitus were excluded.

During the follow up period, 126 patients (55.5 percent) developed biopsy proven cardiovascular disorder and renal allograft dysfunction. In patients without family history (n=158), 36.7 developed cardiovascular disorder and renal allograft dysfunction compared to 62.31 percent of patients with a positive family history (p<0.008).

Patients who developed post-transplant atherosclerosis (group 1, n=23) had the highest ratio of cardiovascular disorder and renal allograft dysfunction (65.2 percent). This value was 60.8 percent in patients with positive family history (group 2, n=46), and 35.2 percent in patients with atherosclerosis but no family history (group 3, n=17).

Among patients with no risk factors (group 4, n=17), 37.0 percent developed cardiovascular disorder and renal allograft dysfunction. There were significant differences between groups 1 and 4 (p<0.02) and between groups 2 and 4 (p<0.003).

Group 1 had significantly higher total cholesterol and total triglyceride levels (p<0.01), and lower albumin levels compared to the other groups (p<0.01).

Dr. Ozdemir concluded that family history could be a risk factor in graft survival and development of cardiovascular disorder and renal allograft dysfunction, and could be related to development of atherosclerosis and detrimental effects on metabolic abnormalities.

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