TY - JOUR
T1 - Cardiovascular risk factors associated with immunosuppression in renal transplantation
AU - Kasiske, Bert L
AU - Ballantyne, Christie M.
PY - 2002
Y1 - 2002
N2 - Cardiovascular disease (CVD) is the leading cause of death among renal transplant recipients with a functioning transplant. The prevalence and severity of CVD in renal transplant recipients are related to numerous factors, most shared with the general population and others specific to transplant recipients, including effects of kidney dysfunction and immunosuppressive drugs. Modern immunosuppressive regimens have allowed a decrease in the dose of corticosteroids, which markedly increase cardiovascular risk. However, each of the 3 agents commonly used as the base for immunosuppressive regimens, cyclosporine, tacrolimus, and sirolimus, may contribute significantly to 1 or more cardiovascular risk factors that are already of substantial concern in this population. Cyclosporine has been associated with the greatest hypertensive effect; tacrolimus, with the greatest impact on diabetes and glycemic control; and sirolimus, with the greatest impact on lipid profiles. This review highlights the major causes of CVD in renal transplant recipients, with particular attention to hypertension, diabetes, and dyslipidemia, and evaluates the contribution of immunosuppressive agents to cardiovascular risk.
AB - Cardiovascular disease (CVD) is the leading cause of death among renal transplant recipients with a functioning transplant. The prevalence and severity of CVD in renal transplant recipients are related to numerous factors, most shared with the general population and others specific to transplant recipients, including effects of kidney dysfunction and immunosuppressive drugs. Modern immunosuppressive regimens have allowed a decrease in the dose of corticosteroids, which markedly increase cardiovascular risk. However, each of the 3 agents commonly used as the base for immunosuppressive regimens, cyclosporine, tacrolimus, and sirolimus, may contribute significantly to 1 or more cardiovascular risk factors that are already of substantial concern in this population. Cyclosporine has been associated with the greatest hypertensive effect; tacrolimus, with the greatest impact on diabetes and glycemic control; and sirolimus, with the greatest impact on lipid profiles. This review highlights the major causes of CVD in renal transplant recipients, with particular attention to hypertension, diabetes, and dyslipidemia, and evaluates the contribution of immunosuppressive agents to cardiovascular risk.
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U2 - 10.1053/trre.2002.28890
DO - 10.1053/trre.2002.28890
M3 - Article
AN - SCOPUS:0036119236
SN - 0955-470X
VL - 16
SP - 1
EP - 21
JO - Transplantation Reviews
JF - Transplantation Reviews
IS - 1
ER -