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Post Kidney Transplant: Cardiovascular Complications

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Kidney Transplant Management

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Abstract

Renal transplantation remains the gold standard treatment to improve survival in end-stage renal disease. Cardiovascular disease, as in the general population, is the front-runner cause of mortality in renal transplant recipients. Congestive heart failure, ischemic heart disease, cerebrovascular disease, arrhythmias, and peripheral arterial disease constitute common causes of cardiovascular events and deaths. Post-transplant inflammatory milieu, immunosuppressive agents, episodes of graft rejection, post-graft failure renal replacement therapy, as well as traditional cardiovascular risk factors, such as hypertension, hyperlipidemia, smoking, obesity, chronic kidney disease, proteinuria, and diabetes mellitus, add to a transplant recipient’s cardiovascular risk profile. Medical management of risk factors include strategies employed in the chronic kidney disease population with credence given to approaches specific for transplant recipients, such as choice of maintenance immunosuppression, steroid tapering or withdrawal, and particular anti-hypertensive regimens. Overall cardiovascular morbidity and mortality in renal transplant recipients has declined, over the last few decades, likely secondary to improved detection and timely management of risk factors. However, this requires delicate balancing of robust induction and maintenance immunosuppression to avoid rejection episodes with meticulous treatment of all cardiovascular risk factors in a transplant recipient.

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  1. Division of Nephrology, Department of Internal Medicine, UT Southwestern, Dallas, TX, USA

    Nashila AbdulRahim, Bekir Tanriover & Venkatesh K. Ariyamuthu

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  1. Department of Medicine, Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Sandesh Parajuli

  2. Department of Medicine, Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Fahad Aziz

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AbdulRahim, N., Tanriover, B., Ariyamuthu, V.K. (2019). Post Kidney Transplant: Cardiovascular Complications. In: Parajuli, S., Aziz, F. (eds) Kidney Transplant Management. Springer, Cham. https://doi.org/10.1007/978-3-030-00132-2_6

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