Use of cardioprotective medications in kidney transplant recipients

R. S. Gaston, B. L. Kasiske, A. M. Fieberg, R. Leduc, F. C. Cosio, S. Gourishankar, P. Halloran, L. Hunsicker, D. Rush, A. J. Matas

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Death with function causes half of late kidney transplant failures, and cardiovascular disease (CVD) is the most common cause of death in these patients. We examined the use of potentially cardioprotective medications in a prospective observational study at seven transplant centers in the United States and Canada. Among 935 patients, 87% received antihypertensive medications at both 1 and 6 months after transplantation. Similar antihypertensive regimens were used for patients with and without diabetes and CVD, but with wide variability among centers. In contrast, while 44% of patients were on angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) at the time of transplantation, the proportion taking these agents dropped to 12% at month 1, then increased to 24% at 6 months. Fewer than 30% with CVD or diabetes received ACEI/ARB therapy 6 months posttransplant. Aspirin use was uncommon (<40% of patients). Even among those with diabetes and/or CVD, fewer than 60% received aspirin and only half received a statin at 1 and 6 months. This study demonstrates marked variability in the use of cardioprotective medications in kidney transplant recipients, a finding that may reflect, among several possible explanations, clinical uncertainty due the lack of randomized trials for these medications in this population.

Original languageEnglish (US)
Pages (from-to)1811-1815
Number of pages5
JournalAmerican Journal of Transplantation
Volume9
Issue number8
DOIs
StatePublished - Aug 2009

Keywords

  • Cardiovascular complications
  • Hypertension
  • Kidney transplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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    Gaston, R. S., Kasiske, B. L., Fieberg, A. M., Leduc, R., Cosio, F. C., Gourishankar, S., Halloran, P., Hunsicker, L., Rush, D., & Matas, A. J. (2009). Use of cardioprotective medications in kidney transplant recipients. American Journal of Transplantation, 9(8), 1811-1815. https://doi.org/10.1111/j.1600-6143.2009.02696.x