Pre-transplant cardiovascular risk factors affect kidney allograft survival: A multi-center study in Korea

Jung Nam An, Song Vogue Ahn, Jung Pyo Lee, Eunjin Bae, Eunjeong Kang, Hack Lyoung Kim, Yong Jin Kim, Yun Kyu Oh, Yon Su Kim, Young Hoon Kim, Chun Soo Lim

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Abstract

Background: Pre-transplant cardiovascular (CV) risk factors affect the development of CV events even after successful kidney transplantation (KT). However, the impact of pre-transplant CV risk factors on allograft failure (GF) has not been reported. Methods and Findings: We analyzed the graft outcomes of 2,902 KT recipients who were enrolled in a multi-center cohort from 1997 to 2012. We calculated the pre-transplant CV risk scores based on the Framingham risk model using age, gender, total cholesterol level, smoking status, and history of hypertension. Vascular disease (a composite of ischemic heart disease, peripheral vascular disease, and cerebrovascular disease) was noted in 6.5% of the patients. During the median follow-up of 6.4 years, 286 (9.9%) patients had developed GF. In the multivariable-adjusted Cox proportional hazard model, pre-transplant vascular disease was associated with an increased risk of GF (HR 2.51; 95% CI 1.66-3.80). The HR for GF (comparing the highest with the lowest tertile regarding the pre-transplant CV risk scores) was 1.65 (95% CI 1.22-2.23). In the competing risk model, both pre-transplant vascular disease and CV risk score were independent risk factors for GF. Moreover, the addition of the CV risk score, the pre-transplant vascular disease, or both had a better predictability for GF compared to the traditional GF risk factors. Conclusions: In conclusion, both vascular disease and pre-transplant CV risk score were independently associated with GF in this multi-center study. Pre-transplant CV risk assessments could be useful in predicting GF in KT recipients.

Original languageEnglish
Article numbere0160607
JournalPloS one
Volume11
Issue number8
DOIs
Publication statusPublished - 2016 Aug

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    An, J. N., Ahn, S. V., Lee, J. P., Bae, E., Kang, E., Kim, H. L., Kim, Y. J., Oh, Y. K., Kim, Y. S., Kim, Y. H., & Lim, C. S. (2016). Pre-transplant cardiovascular risk factors affect kidney allograft survival: A multi-center study in Korea. PloS one, 11(8), [e0160607]. https://doi.org/10.1371/journal.pone.0160607