End Stage Renal Disease (ESRD), is the last stage of chronic kidney disease that requires dialysis or transplant. Kidney diseases are known to cause several cardiovascular diseases.
A new study by Dr April Jorge and team has reported that kidney transplant showed reduced risks of cardiovascular diseases like Myocardial Infarction (MI) and Cerebrovascular accident (CVA) in patients of CKD. The study is published in Arthiritis Care & Research journal.
The objective of the study was to evaluate the potential impact of kidney transplantation on cardiovascular (CV) events among patients with ESRD due to lupus nephritis (LN).
The study was designed as a nationwide cohort study, all patients with LN-ESRD were enrolled in the United States Renal Data System who were waitlisted for a kidney transplant and enrolled in Medicare between January, 2000 and December, 2016. The primary outcome was incident CV events, including myocardial infarctions (MI) and ischemic cerebrovascular accidents (CVA). A time-dependent Cox regression was used to estimate the hazard ratios (HRs) of these outcomes associated with kidney transplant as a time-varying exposure, adjusting for sex, age, race, ethnicity, geographic region, year of ESRD onset, first ESRD treatment modality (e.g., hemodialysis or peritoneal dialysis), Charlson comorbidity score, and history of prior organ transplants.
The results of the study were found to be
• A total of 5,963 waitlisted patients with LN-ESRD, 3,209 (54%) had a kidney transplant during the study period.
• The majority were female (82%), and African Americans represented 48% of waitlisted patients and 43% of transplanted patients.
• Kidney transplantation was associated with a lower risk of incident CV events (adjusted HR 0.31 [95% CI 0.18-0.53]) as well as lower risks of MI and CVA (adjusted HRs 0.13 [95% CI 0.08-0.34] and 0.30 [95% CI 0.16-0.54], respectively).
Jorge and team concluded that "Kidney transplantation was associated with a reduced risk of CV events, including MI and CVA, in patients with LN-ESRD. Our findings highlight the importance of identifying barriers to transplantation in this population, as improved access could reduce CV morbidity."
For further information: Jorge A, Fu X, Cook C, et al. "Kidney transplantation and cardiovascular events among patients with end-stage renal disease due to lupus nephritis: a nationwide cohort study." Arthritis Care Res, 2021. doi:10.1002/acr.24725
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