Macrovascular disease in Sri Lankan kidney transplant recipients

Abstract

Macrovascular diseases such as angina, myocardial infarction, stroke and peripheral occlusive arterial disease are common causes of mortality and morbidity in transplant patients. To study the frequency and determinants if vascular disease in Sri Lankan patients with renal transplants. A cohort of 237 renal transplant recipients (163 males (76%),mean age 35.09, SD 11.05 years). Patients under follow up at the Faculty Of Medicine Transplant program. Prospective study of a cohort of patients. Macrovascular diseases developed in 42% of transplant recipients. 5.6% had transient ischaemic attacks, 2.8% strokes, 18.2% angina, 8.4%myocardial infarctions, 2.3%underwent lower extremity amputations because of vascular insufficiency, 7% peripheral vascular occlusive disease and 4!).5% were hypertensive. Male sex (odds ratio of 2.87, 95% CI 1.33- 6.85, p = 0.006), serum cholesterol greater than 6.2 mmol/l at transplant (odds ratio 8.60, 95% CI 2.53-38.9, p= 0.0001) at 5 years after transplant (odds ratio 10.25,95%CI 1.22-22.9,P = 0.01) were associated with a higher risk of macrovascular disease. Pre-transplant diabetes was associated with a higher risk of macrovascular disease and lower extremity amputation (odds ratio 4.53, 95% CI 1.32-6.76, p = 0.007). Strategies to screen for and treat potential risk factors should form an integral part of the follow up for Sri Lankan and Asian kidney transplant recipients.