Mohinder R Vindhyal, Sahith Mandala, Wan-Chi Chan, Rhythm Vasudeva, Suveenkrishna Pothuru, Harsh Mehta, Sania Jiwani, Kamal Gupta
{"title":"Cardiovascular outcomes in kidney transplant patients with pre-existing peripheral arterial disease and diabetes mellitus.","authors":"Mohinder R Vindhyal, Sahith Mandala, Wan-Chi Chan, Rhythm Vasudeva, Suveenkrishna Pothuru, Harsh Mehta, Sania Jiwani, Kamal Gupta","doi":"10.1024/0301-1526/a001201","DOIUrl":null,"url":null,"abstract":"<p><p><b></b> <i>Background:</i> Kidney transplantation (KT) has been shown to enhance the quality of life, be more cost-effective, and reduce mortality in dialysis patients. We aimed to study the impact of pre-existing diabetes mellitus (DM) and peripheral arterial disease (PAD) on cardiovascular outcomes and mortality after kidney transplantation (KT). <i>Materials and methods:</i> A secondary USRDS (United States Renal Data System) analysis was performed from 2006 to 2017 in adult patients who underwent KT. The primary outcome was 3-year all-cause mortality, and secondary outcomes were myocardial infarction (MI), cerebrovascular accident, gangrene/limb ischemia, and graft failure. Adjusted hazard ratios were computed, and multivariate analysis was conducted. All p-values were 2-sided, and a value of <0.05 was deemed to be statistically significant. Statistical analyses were performed using the SAS 9.4 software. <i>Results:</i> A total of 51,009 patients with kidney transplants met the study inclusion/ exclusion criterion. Patients with both DM and PAD had the highest risk of mortality (15.3%, aHR 1.8, 1.6-2.0), followed by patients with PAD without DM (14.1%, aHR 1.6, 1.4-1.9), DM without PAD (9.9%, aHR 1.4, 1.3-2.6), and those without either DM or PAD (5.5%). MI was also higher in patients with DM and PAD (7.3%, aHR 1.8, 1.5-2.2), followed by DM alone (4.6%, aHR 1.58, 1.4-1.7), PAD alone (4.3%, aHR 1.14, 0.8-1.6), and no diabetes nor PAD (2.2%). <i>Conclusions:</i> In patients undergoing KT, those with pre-existing DM and/ or PAD have a significantly higher all-cause mortality and risk of MI.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"235-241"},"PeriodicalIF":2.4000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vasa-european Journal of Vascular Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1024/0301-1526/a001201","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Kidney transplantation (KT) has been shown to enhance the quality of life, be more cost-effective, and reduce mortality in dialysis patients. We aimed to study the impact of pre-existing diabetes mellitus (DM) and peripheral arterial disease (PAD) on cardiovascular outcomes and mortality after kidney transplantation (KT). Materials and methods: A secondary USRDS (United States Renal Data System) analysis was performed from 2006 to 2017 in adult patients who underwent KT. The primary outcome was 3-year all-cause mortality, and secondary outcomes were myocardial infarction (MI), cerebrovascular accident, gangrene/limb ischemia, and graft failure. Adjusted hazard ratios were computed, and multivariate analysis was conducted. All p-values were 2-sided, and a value of <0.05 was deemed to be statistically significant. Statistical analyses were performed using the SAS 9.4 software. Results: A total of 51,009 patients with kidney transplants met the study inclusion/ exclusion criterion. Patients with both DM and PAD had the highest risk of mortality (15.3%, aHR 1.8, 1.6-2.0), followed by patients with PAD without DM (14.1%, aHR 1.6, 1.4-1.9), DM without PAD (9.9%, aHR 1.4, 1.3-2.6), and those without either DM or PAD (5.5%). MI was also higher in patients with DM and PAD (7.3%, aHR 1.8, 1.5-2.2), followed by DM alone (4.6%, aHR 1.58, 1.4-1.7), PAD alone (4.3%, aHR 1.14, 0.8-1.6), and no diabetes nor PAD (2.2%). Conclusions: In patients undergoing KT, those with pre-existing DM and/ or PAD have a significantly higher all-cause mortality and risk of MI.
期刊介绍:
Vasa is the European journal of vascular medicine. It is the official organ of the German, Swiss, and Slovenian Societies of Angiology.
The journal publishes original research articles, case reports and reviews on vascular biology, epidemiology, prevention, diagnosis, medical treatment and interventions for diseases of the arterial circulation, in the field of phlebology and lymphology including the microcirculation, except the cardiac circulation.
Vasa combines basic science with clinical medicine making it relevant to all physicians interested in the whole vascular field.