Renal dysfunction as a risk factor for mortality and cardiovascular disease in renal transplantation: experience from the Assessment of Lescol in Renal Transplantation trial

Fellström, Bengt,1947-Uppsala universitet,Institutionen för medicinska vetenskaper,Njurmedicin, The ALERT trial (author)

Renal dysfunction as a risk factor for mortality and cardiovascular disease in renal transplantation : experience from the Assessment of Lescol in Renal Transplantation trial

BACKGROUND: Renal-transplant recipients have shortened life expectancy primarily because of premature cardiovascular disease. Traditional and nontraditional risk factors for cardiovascular disease are prevalent in renal patients. In renal-transplant recipients, immunosuppressive therapy can be nephrotoxic and aggravate cardiovascular disease risk factors. Renal dysfunction has been established as a risk factor for cardiovascular disease and mortality in different populations. We evaluated the effects of baseline renal-transplant function on mortality and cardiovascular and renal endpoints in 1,052 placebo-treated patients of the Assessment of Lescol in Renal Transplantation trial. METHODS: All renal-transplant recipients were on cyclosporine-based immunosuppressive therapy. Follow-up was 5 to 6 years, and endpoints included cardiac death, noncardiovascular death, all-cause mortality, major adverse cardiac event (MACE), stroke, nonfatal myocardial infarction, and graft loss. RESULTS: Baseline serum creatinine was strongly and independently associated with increased cardiac, noncardiovascular, and all-cause mortality, as well as MACE and graft loss. Serum creatinine was not a risk factor for stroke or nonfatal myocardial infarction. CONCLUSIONS: Elevated baseline serum creatinine in renal-transplant recipients is a strong and independent risk factor for all-cause, noncardiovascular and cardiac mortality, MACE, and graft loss.

Jardine, Alan G.The ALERT Trial (author)
Soveri, IngaUppsala universitet,Institutionen för medicinska vetenskaper,Njurmedicin, The ALERT Trial(Swepub:uu)insov254 (author)
Cole, EdwardThe ALERT Trial (author)
Grönhagen-Riska, CarolaThe ALERT Trial (author)
Neumayer, Hans H.The ALERT Trial (author)
Maes, BartThe ALERT Trial (author)
Gimpelewicz, ClaudioThe ALERT Trial (author)
Holdaas, HallvardThe ALERT Trial (author)
Uppsala universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

In:Transplantation: Lippincott, Williams and Wilkins79:9, s. 1160-11630041-13371534-6080

By the author/editor: Fellström, Bengt ...; Jardine, Alan G.; Soveri, Inga; Cole, Edward; Grönhagen-Riska, ...; Neumayer, Hans H ...; show more...; Maes, Bart; Gimpelewicz, Cla ...; Holdaas, Hallvar ...; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Urology and Neph ...

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