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Kidney Week

Abstract: SA-PO1070

Association Between Clinical Atherosclerotic Cardiovascular Disease and Some Kidney Transplant Outcomes: A Retrospective Study

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Adeyemi, Emmanuel Olusola, Saint Peter's University Hospital, New Brunswick, New Jersey, United States
  • Nebuwa, Chikodili N., Nuvance Health, Poughkeepsie, New York, United States
  • Oke, Oluwabunmi Anuoluwapo, Heatherwood Hospital, Ascot, Berkshire, United Kingdom
  • Dwivedi, Shaunak A., Saint Peter's University Hospital, New Brunswick, New Jersey, United States
Background

Atherosclerotic cardiovascular disease (ASCVD) is a common comorbidity in patients with end stage renal disease that eventually get a kidney transplant. This study seeks to explore the association between clinical ASCVD and specific kidney transplant outcomes.

Methods

This study used the 2010-2022 data from the Scientific Registry of Transplant Recipients (SRTR). The SRTR data system includes data on all donors, waitlisted candidates and transplant recipients in the US submitted by the members of the Organ Procurement and Transplantation Network (OPTN). The Health Resources and Services Administration (HRSA), US Department of Health and Human Services provides oversight to the activities of the OPTN and SRTR contractor. Independent variables in our study include history of angina/coronary artery disease, history of peripheral vascular disease, history of cerebrovascular disease. Kidney transplant outcomes in this study include acute graft rejection, delayed graft function (measured in this study as failure of creatinine decline by 25% or more in the first 24hrs) and graft failure. Chi square was used to explore the association between atherosclerotic cardiovascular disease and kidney transplant outcomes.

Results

There were 108,927 kidney transplant recipients. 8,146 (7.5%) patients had clinical atherosclerotic cardiovascular disease. 2.5% of patients with clinical ASCVD vs 2.2% of patients without clinical ASCVD developed acute graft rejection (P-value=0.0401). 61.7% of patients with clinical ASCVD vs 52.5% of patients without clinical ASCVD developed delayed graft function (P-value=<0.0001). 1.7% of patients with clinical ASCVD vs 1.4% of patients without clinical ASCVD developed graft failure (P=0.0091).

Conclusion

Our study has shown that pretransplant atherosclerotic cardiovascular disease is a risk factor for acute graft rejection, delayed graft function and graft failure. This finding highlights the importance of both primary and secondary prevention of atherosclerotic cardiovascular disease in chronic kidney disease patients.