Fernández-Fresnedo G, Gómez-Alamillo C, Ruiz J C, de Francisco A L M, Arias M
Nephrology Service, University Hospital Marqués de Valdecilla, Santander, Spain.
Transplant Proc. 2009 Jun;41(5):1637-8. doi: 10.1016/j.transproceed.2009.02.075.
Kidney transplantation is the treatment of choice for patients with end-stage renal disease. Despite improvements in short-term patient and graft outcomes, there has been no major improvement in long-term outcomes. The aim of this study was to determine the prevalence of cardiovascular risk factors, such as hypertension, dyslipidemia, diabetes, chronic kidney disease, and obesity, and the impact of their control among 526 stable renal transplant recipients according to the guidelines in the general population. Mean blood pressure was 133 +/- 16/81 +/- 9 mm Hg. The proportion of patients on antihypertensive therapy was 75%, and on ACE inhibitors or angiotensin II receptor blockers, 26%. The mean cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides were 195 +/- 41, 115 +/- 32, 51 +/- 17, and 137 +/- 75 mg/dL, respectively. The proportion of patients on statin treatment was 49.7%, and those with body mass indices between 25 and 30, 30 and 35, and >35 kg/m(2) were 35%, 15%, and 4%. We observed a high prevalence of chronic kidney disease, hypertension, dyslipidemia, and obesity among renal transplant patients. Suboptimal control was frequent and control of some of these complications was far below targets established for nontransplant patients despite progressive intensification of therapy with functional graft decline. The findings of this study may have an impact on the management of renal transplant recipients.
肾移植是终末期肾病患者的首选治疗方法。尽管患者和移植物的短期预后有所改善，但长期预后并无重大改善。本研究的目的是根据一般人群的指南，确定526例稳定的肾移植受者中高血压、血脂异常、糖尿病、慢性肾脏病和肥胖等心血管危险因素的患病率及其控制情况。平均血压为133±16/81±9 mmHg。接受抗高血压治疗的患者比例为75%，接受ACE抑制剂或血管紧张素II受体阻滞剂治疗的患者比例为26%。平均胆固醇、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）和甘油三酯分别为195±41、115±32、51±17和137±75 mg/dL。接受他汀类药物治疗的患者比例为49.7%，体重指数在25至30、30至35和>35 kg/m²之间的患者比例分别为35%、15%和4%。我们观察到肾移植患者中慢性肾脏病、高血压、血脂异常和肥胖的患病率较高。尽管随着移植肾功能下降治疗逐渐强化，但这些并发症的控制常常欠佳，其中一些并发症的控制远低于为非移植患者设定的目标。本研究结果可能会对肾移植受者的管理产生影响。
