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Vascular Damage and Kidney Transplant Outcomes: An Unfriendly and Harmful Link
Ist Teil von
The American journal of the medical sciences, 2017-07, Vol.354 (1), p.7-16
Ort / Verlag
United States: Elsevier Inc
Erscheinungsjahr
2017
Quelle
MEDLINE
Beschreibungen/Notizen
Abstract Kidney transplant (KT) is the treatment of choice for most chronic kidney disease patients, but these have a high cardiovascular mortality due to traditional and non-traditional risk factors, including vascular calcification. Inflammation could precede the appearance of artery wall lesions, leading to arteriosclerosis and clinical and subclinical atherosclerosis in these patients. Additionally, mineral metabolism disorders and activation of the renin-angiotensin system could contribute to this vascular damage. Thus, understanding the vascular lesions that occur in KT recipients and the pathogenic mechanisms involved in their development could be crucial to optimize the therapeutic management and outcomes in terms of survival of this population. This review focuses on the following issues: 1) epidemiological data framing the problem; 2) atheromatosis in KT patients: subclinical and clinical atheromatosis, involving ischemic heart disease, congestive heart failure, stroke and peripheral vascular disease; 3) arteriosclerosis and vascular calcifications; and 4) potential pathogenic mechanisms and their therapeutic targets.