Chapters authored
Cardiovascular Diseases in Patients with Renal Transplantation
Kidney transplantation has become the primary method of treating severe chronic renal failure. The first successful kidney transplant was performed in 1954 in Boston, the graft was in function for 7 years, and patient died because of the heart disease. Cardiovascular disease is the leading cause of death in patients with a transplanted kidney. Despite the fact that patients with a transplanted kidney are highly susceptible to infections and have an increased tendency to develop malignant diseases, these patients die mainly of cardiovascular disease. Patients with a transplanted kidney are exposed to atherogenic risk which is associated with previous dialysis treatment and the use of immunosuppressive drugs. An excessive risk of developing cardiovascular disease in patients with a transplanted kidney is due to the high frequency and accumulation of atherogenic risk factors before and after transplantation. Pre-transplant cardiovascular disease is a major risk factor for the development of post-transplant cardiovascular disease. Risk factors for the development of cardiovascular diseases in patients with a transplanted kidney are divided into traditional and nontraditional. Traditional risk factors such as immutable (age, gender, and inheritance) and variable (smoking, hyperlipidemia, hypertension, obesity, diabetes mellitus, physical activity, stress). Nontraditional risk factors such as risk factors related to the status of transplantation and its treatment and risk factors associated with chronic regression in allograft function. The most common cardiovascular diseases in patients after kidney transplantation are as follows: ischemic heart disease, congestive heart failure and left ventricular hypertrophy. Of all cardiovascular complications, ischemic heart disease is by far the most common cause of mortality (more than 50%) in patients with a transplanted kidney. Frequency of left ventricular hypertrophy ranges from 50 to 70% in patients with a transplanted kidney. Early detection of high-risk patients for the development of cardiovascular diseases allows timely application of an appropriate therapeutic strategy that ensures high survival rates for patients with a transplanted kidney.
Part of the book: Organ Donation and Transplantation