Abstract
Purpose: Cardiovascular disease (CVD) is the most common cause for mortality in kidney transplant (Ktx) recipients. The purpose of this study was to describe prevalence of cardiovascular disease and CVD risk factors in 356 Ktx recipients participating in the Supporting Medication Adherence in Renal Transplantation (SMART) study.
Method: This cross-sectional study included 356 adult Ktx recipients >1 year post-Ktx (207 men, 149 women) with a mean age of 53 years (±12.6) and a median of 6 years (IQR=8.3) post-Ktx. Prevalence of CVD was defined as having had a myocardial infarction, and/or having coronary artery disease, and/or congestive heart disease, and/or peripheral artery disease. Risk factors for CVD assessed were lipids (i.e. total cholesterol, total cholesterol/HDL quotient, HDL, LDL, triglycerides), body mass index (BMI), diabetes, smoking, and living alone. This information was subtracted from medical files or through patient interviews (smoking, living alone). Depressive symptomatology was assessed using the Beck Depression Inventory (BDI). Descriptive statistics were mean/S.D., median/IQR, and frequencies as appropriate.
Results: Prevalence of CVD in this sample of KTx was 30% (n=107). 43.5% of Ktx (n=155) had a total cholesterol of >5.20mmol/l; 21.1% Ktx (n=75) had total cholesterol/HDL quotient ≥5.0 mmol/1; 24.7% (n=88) had LDL >3.40mmol/l. Men and women had a mean BMI of 25.7±4.1, and 25.0±4.0, respectively. Of the men, 36.7% (n=76) had BMI 25–30, 14.5% (n=30) had BMI >30. Of the women, 44.3% (n=66) had BMI 24–30, 12.1% (n=18) had BMI >30. 21.3% (n=76) had diabetes (type I: 8.7%; type II: 12.6%), 21.3% actually smoked, and 23.3% (n=83) lived alone. 75% (n=267) were screened to have no depressive symptomatology, 15.4% (n=55) were slightly, 6.5% (n=23) were moderately, and 3.1% (n=11) were severely depressed, respectively.
Conclusion: Cardiovascular disease and CVD risk factors (i.e. lipids above recommended range, overweight and obesity, smoking, social isolation, and depression) were highly prevalent in Ktx-recipients. The study findings substantiate the high-risk profile of Ktx recipients for having or developing cardiovascular disease. Our findings indicate that it is necessary to pay attention to life style factors and modifiable psychosocial factors within a preventive framework for populations at risk or patients with already established CVD.