EARLY PREDICTION OF CARDIOVASCULAR DISEASE IN KIDNEY TRANSPLANT RECIPIENTS

Cardiovascular disease (CVD) is frequent in kidney transplant (Tx). This study investigated CVD prediction in kidney Tx by information available pre-Tx or within six months post-Tx. Study cohort consisted of 629 patients with Tx in 2005-10 and with adult age at Tx. Endpoint was the incidence up to 2015 of CVD (coronary heart disease, cerebrovascular disease, peripheral artery disease). Graft failure, non-CVD death with functioning graft, and loss to follow-up were considered competing events. CVD prediction was investigated for thirty-four variables using competing-risks regression. Follow-up range was 0.28-10.00 years (mean±SD= 7.30±3.10). First incident event was CVD in 103 patients and competing events in 146 patients. In multi-variable model for pre-Tx variables only, CVD predictors were male sex (hazard ratio= 1.68, 95%CI= 1.06/2.66), diabetic nephropathy (6.63, 1.81/24.35), pre-Tx dialysis for ≥5 years (1.52, 1.02/2.27), pre-Tx CVD (4.87, 2.84/8.35), age at Tx ≥45 years (2.98, 1.83/4.87). In model for pre-Tx and post-Tx variables together, the sole post-Tx CVD predictor was estimated glomerular filtration rate <60 mL/min at the 6-month visit (1.75, 1.11/2.77). Diabetic nephropathy, pre-Tx dialysis, pre-Tx CVD, and age at Tx predicted 91.2% of incident CVD. Early available information effectively predicted CVD in kidney Tx independent of competing events.