CHARACTERISING CARDIOVASCULAR RISK IN A COHORT OF KIDNEY TRANSPLANT RECIPIENTS – NEXT STEPS IN OPTIMISING CARE.
Dr Gheed Al Maraee1,2, Professor Natasha Rogers1,2
1Renal and Transplant Unit – Westmead Hospital, Westmead, Australia, 2Centre for Transplant and Renal Research, Westmead Institute for Medical Research, Westmead, Australia
Background: Transplantation is the renal replacement therapy of choice for reducing mortality. Nonetheless, kidney transplant recipients experience up to 50 times the annual rate of major adverse cardiovascular (CV) events compared to the general population. CV risk factors include traditional (hypertension, diabetes) and non-traditional (uremic toxins, immunosuppression) influences. The focus of clinical care post-transplantation is centred around optimising immunosuppression to prevent allograft failure, rather than addressing a primary cause of patient death.
Aim: The aim of this study is to describe the incidence of cardiovascular disease in a cohort of deceased-donor kidney transplant recipients.
Method: We performed a single-centre audit of patients receiving a deceased donor kidney transplant at Westmead Hospital between 2016 and 2022. Patient data was extracted from ANZDATA, demographic and medical data were collected from electronic medical records, and statistical analysis was performed using SPSS.
Results: N=40 patients demonstrated allograft function <1 year, n=221 patients had <5 years’ and n=139 patients had >5 years’ graft function. The prevalence of cardiovascular disease prior to transplantation was 29% (n=116). 88% of patients had hypertension (n = 350), 55% had hypercholesterolaemia (n=219), and 30% had diabetes (n=120). The cumulative incidence of cardiac disease at 1-year follow-up was 2.76% and 4.30% at 5-year follow-up in those with no previous cardiac disease. The incidence of cardiovascular events post-transplantation was lower in those who were receiving angiotensin-receptor-blockers (ARB) for treatment of hypertension (RR=0.46), but higher in those receiving calcium channel blockers (RR=1.17) or beta-blockers (RR 3.11).
Conclusion: The cumulative incidence of cardiovascular disease in our cohort increased with length of time post transplantation. Further work is need to identify appropriate CV risk management.
Biography:
Dr Gheed Al Maraee is a basic physician trainee working within the Western Sydney Local Health District. Since completing her Bachelor of Medicine/ Bachelor of Surgery in 2020 at James Cook University, she has developed a keen interest in nephrology and transplantation medicine, and a budding interest in exploring life as a clinician scientist. She aspires to contribute to these fields by producing creative and original evidence-based research.