Kidney Week

Abstract: SA-PO0424

Advanced Cardiovascular-Kidney-Metabolic Syndrome Stage and Early eGFR Recovery After Kidney Transplantation

Session Information

• CKM: Clinical - Epidemiology and Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Chalermchat, Thanasin, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, United States

Thanasin Chalermchat

• Asawaroekwisoot, Thanin, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, United States

Thanin Asawaroekwisoot, MD

• Deepan, Natee, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, United States

Natee Deepan, MD

• Ansusinha, Parinda, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, United States

Parinda Ansusinha, MD

• Ngamvirojcharoen, Boonyasit, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, United States

Boonyasit Ngamvirojcharoen, MD

• Tangprasittichok, Nathasith, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, United States

Nathasith Tangprasittichok, MD

• Bunyawannukul, Issaree, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, United States

Issaree Bunyawannukul, MD

• Kookanok, Chutawat, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States

Chutawat Kookanok, MD

• Kulthamrongsri, Narathorn, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States

Narathorn Kulthamrongsri, MD

• Siwawut, Katanyu, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States

Katanyu Siwawut, MD

• Limpiwattakee, Suppalux, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States

Suppalux Limpiwattakee, MD

• Arpornsujaritkun, Nuttapon, Excellence Center for Organ Transplantation, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Nuttapon Arpornsujaritkun, MD

• Jittirat, Arksarapuk, Division of Nephrology and Hypertension, Department of Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States

Arksarapuk Jittirat, MD

• Buadee, Settawut, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, United States

Settawut Buadee, MD

• Vutthikraivit, Possawat, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States

Possawat Vutthikraivit, MD

• Chuenchaem, Urairat, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States

Urairat Chuenchaem, MD

• Pleanrungsi, Darinorn, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States

Darinorn Pleanrungsi, MD

• Lauhawatana, Burin, Excellence Center for Organ Transplantation, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Burin Lauhawatana, MD

• Kasebuthtaweewat, Yodsaphong, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States

Yodsaphong Kasebuthtaweewat, MD

• Wiwattanathum, Punlop, Excellence Center for Organ Transplantation, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Punlop Wiwattanathum, MD

• Noree, Wanprapit, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States

Wanprapit Noree, MD

• Silprasert, Raynah Roypim, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States

Raynah Roypim Silprasert

• Tantisattamo, Ekamol, American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, United States

Ekamol Tantisattamo, MD, MPH, FASN

Background

Cardiovascular-kidney-metabolic (CKM) syndrome integrates cardiovascular, kidney, and metabolic risk into a unified staging framework. Whether advanced CKM stage is associated with a decline in early post-transplant kidney function recovery and cardiovascular-kidney outcomes in kidney transplant recipients remains uncertain.

Methods

A single center retrospective cohort included adult kidney transplant recipients (KTR) with available data to obtain CKM stages at 3 months post-transplant between 2022 to 2025. Recipients with CKM stage 2 or 3 were categorized as early-stage CKM, whereas those with CKM stage 4a or 4b were categorized as advanced-stage CKM. The primary outcome was ≥25% increase in eGFR from the baseline eGFR at 3-month post-transplant to eGFR at 6 months post-transplant. The association was examined by multivariable Cox-regression analyses were adjusted for age, sex, race and ethnicity.

Results

From 92 eligible KTR, the majority had CKM stage 2 (36 KTR), followed by those with CKM stage 3 (31 KTR), stage 4a (24 KTR), and stage 4b (1 KTR).. Among 72 KTR with available eGFR at 3-month post-transplant, advanced-stage CKM had a lower proportion of KTR with increased eGFR from 3 to 6 months post-transplant compared to early-stage CKM (3/22 [13.6%] vs. 20/50 [40.0%]; P 0.031). Compared to KTR with an early-stage CKM, those with an advanced-stage CKM had shown 79% lower risk of eGFR improvement (HR 0.21, 95% CI 0.05-0.92; P 0.039). After adjusting for age, sex, race and ethnicity, the magnitude and direction of the association remained (aHR 0.25, 95% CI 0.05-1.17; P 0.079). Major Adverse Cardiovascular Events (MACE) occurred more frequently in advanced-stage CKM than in early stage CKM (3/25 [12.0%] vs 0/67 [0.0%] ; P 0.018), whereas rejection and graft failure did not differ significantly between 2 groups.

Conclusion

In this single-center cohort study, advanced-stage CKM was associated with a chance of early eGFR improvement within 6-month post-transplant, and had greater risk of MACE. Longitudinal studies are required to prognosticate the long-term outcomes.