Carotid Intima-media Thickness And Cardiovascular Risk Factors In Kidney Transplant Recipients At A South African Transplant Center

Keywords: Cardiovascular risk factors Carotid intima-media thickness Kidney transplant recipients South Africa. Background: Cardiovascular diseases (CVD) are more common in kidney transplant recipients (KTRs) than in the general population. Carotid intima-media thickness (cIMT) is a marker of atherosclerosis in the general and transplant populations. We determined the prevalence and predictors of cardiovascular risk among KTRs at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and examine the relationship between cardiovascular risk factors and carotid intima media thickness. Methods: Adult recipients of kidney transplant were recruited. Patients records were assessed for information on post transplant follow up. Echocardiography and carotid Doppler were done for all patients. The Framingham Risk Score was used to categorize patients CVD risk. Appropriate inferential and modelling statistics applied as appropriate using SPSS 17, and p value of ≤ 0.05 considered significant.Results: One hundred (KTRs), 63 male (63%), were recruited with mean age of 42.2 ± 12.42 years. Thirty six percent have high cardiovascular risk. The mean ± SD cIMT of the study population was 0.62 ± 0.21 mm with a range of 0.42 to 1.45 mm; 14 patients (14%) had carotid artery plaque. Twenty five percent had cIMT of > 0.7 mm. Carotid intima-media thickness correlated with CVD risk. Multiple regression analysis showed proteinuria (p = 0.022), higher cumulative steroid dose (p = 0.028), elevated serum triglycerides (p = 0.04) and the presence of plaques in the carotid artery (p = 0.012) as predictors of high cardiovascular risk. Conclusion: KTRs in Johannesburg have high cardiovascular risk, and cIMT correlated with this high CVD risk.