NDT Advance Access first published online on March 30, 2006
This version published online on May 25, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl095
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1 Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Biochemistry, Tartu University, Tartu, Estonia
* To whom correspondence should be addressed. Background. Renal transplant recipients (RTR) mainly die of premature cardiovascular disease. Traditional cardiovascular disease risk factors are prevalent in RTR. Additionally, non-traditional risk factors seem to contribute to the high risk. The impact of renal dysfunction was compared with traditional risk factors for cardiovascular morbidity and mortality in 1052 placebo-treated patients of the ALERT trial. Methods. All patients were on cyclosporine-based immunosuppressive therapy, follow-up was 5-6 years and captured endpoints included cardiac death, non-cardiovascular death, all-cause mortality, major adverse cardiac event (MACE), non-fatal myocardial infarction (MI) and stroke. Results. A calculated 84 µmol/l increase in serum creatinine was needed to double the risk for cardiac death, an increase of 104 µmol/l to double the risk for non-cardiovascular death and an increase of 92 µmol/l to double the risk for all-cause mortality. MACE risk was doubled if serum creatinine was elevated by 141 µmol/l, age was increased by 23 years, or LDL-cholesterol by 2 mmol/l. Diabetes increased the incidences of cardiac death, all-cause mortality, MACE, stroke and non-fatal MI. A serum creatinine increase of 130 µmol/l, or Conclusion. An increase in serum creatinine of 80-100 µmol/l doubles the risk for cardiac death, non-cardiovascular death and all-cause mortality in RTR. An increase of 130 µmol/l in serum creatinine or "To double the RR for non-fatal MI in RTR, 35 years increment in age or 2.0 mmol/l increment in LDL-cholesterol was needed" has been changed to "...23 years..." in Section "Doubling of risk". In Table 3, Non-fatal MI the age in years has been changed from 35 to 23.
Received December 19, 2005
Accepted February 20, 2006
Original Article
Renal transplant dysfunction--importance quantified in comparison with traditional risk factors for cardiovascular disease and mortality
Inga Soveri 1 *,
Hallvard Holdaas 2,
Alan Jardine 3,
Claudio Gimpelewicz 4,
Beatrix Staffler 4,
and
Bengt Fellström 5
2 Rikshospitalet, Oslo, Norway
3 University of Glasgow, Glasgow, UK
4 NOVARTIS, Basel, Switzerland
5 Department of Medical Sciences, Uppsala University, Uppsala, Sweden
Inga Soveri, E-mail: inga.soveri{at}medsci.uu.se
Abstract 
20 years increase in age was calculated as similar in risk for cardiac death, all-cause mortality and MACE, and comparable to risk of diabetes in RTR.20 years increase in age is comparable to risk of diabetes.
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