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Abstract: FR-PO1132

Cardiovascular Disease After Kidney Transplantation: A Nationwide Study in South Korea

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Kim, Ji Eun, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Park, Sehoon, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Yong Chul, SNUH, Seoul, Korea (the Republic of)
  • Yu, Mi-yeon, Hanyang University Guri Hospital, Gyeonggi, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
Background

Cardiovascular disease (CVD) is the most common cause of death in end-stage renal disease (ESRD). Kidney transplantation (KT) is an effective treatment for ESRD, and is known as lowering risk for CVD compared to the ESRD patients on the transplantation waiting list. However, there is a lack of large-population studies especially for Asians.

Methods

We analyzed the nationwide health insurance database of South Korea and identified patients who received kidney transplantation from the year of 2007 to 2015. Patients who were under 20 years of age, had previous CVD identified, or had multiorgan transplantation were excluded from the study. As controls, ESRD and GP groups were extracted after same exclusion and matching with KT recipients by age, sex, and inclusion year. CVD was defined as major cardiovascular events (MACEs) consisted of myocardial infarction, ischemic stroke, and all-cause mortality.

Results

During the study period, a total of 13,179 patients received KT. After exclusion, 4,156 KT recipients were selected. The same number of ESRD and GP control were extracted after matching. Mean age was 41.3 ± 10.2 years and 55.2% were men in all 3 groups. KT recipients had similar proportions of diabetes and hypertension and a lower proportion of dyslipidemia compared with ESRD controls, although significantly higher co-morbidities than GP controls. The total number of MACEs was 76 (3.7 per 1000 person-year) in KT recipients, 377 (21.7 per 1000 person-year) in ESRD, 51 (2.5 per 1000 person-year) in GP, respectively. KT recipients showed a significantly lower MACE risk (adjusted HR 0.16, 95% CI 0.12-0.20, p <0.001) than ESRD controls. And the MACE risk were not significantly different between KT recipients and matched GP controls (adjusted HR 0.81, 95% CI 0.52-1.27, p=0.365). When subgroup analysis of age, sex, diabetes and hypertension was performed, similar trends were observed regardless of subgroups.

Conclusion

In this study, we found that the KT recipients had a lower risk of newly onset MACE after transplantation compared to patients maintaining dialysis in Korea, and showed a similar MACE risk compared to the general population.