Macrovascular disease in Sri Lankan kidney transplant recipients.

ABSTRACT

INTRODUCTION: Macrovascular diseases such as angina, myocardial infarction, stroke and peripheral occlusive arterial disease are common causes of mortality and morbidity in transplant patients. OBJECTIVES: To study the frequency and determinants if vascular disease in Sri Lankan patients with renal transplants. PATIENTS A cohort of 237 renal transplant recipients (163 males (76%), mean age 35.09, SD 11.05 years). SETTING: Patients under follow up at the Faculty of Medicine Transplant program. METHOD: Prospective study of a cohort of patients. RESULTS: 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 49.5% 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). CONCLUSIONS: 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.