Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee.
Division of Nephrology, Department of Medicine, University of California, San Francisco, California.
Clin J Am Soc Nephrol. 2021 Dec;16(12):1878-1889. doi: 10.2215/CJN.00520121. Epub 2021 Sep 23.
Cardiovascular disease remains a leading cause of death and morbidity in kidney transplant recipients and a common reason for post-transplant hospitalization. Several traditional and nontraditional cardiovascular risk factors exist, and many of them present pretransplant and worsened, in part, due to the addition of immunosuppression post-transplant. We discuss optimal strategies for identification and treatment of these risk factors, including the emerging role of sodium-glucose cotransporter 2 inhibitors in post-transplant diabetes and cardiovascular disease. We present common types of cardiovascular disease observed after kidney transplant, including coronary artery disease, heart failure, pulmonary hypertension, arrhythmia, and valvular disease. We also discuss screening, treatment, and prevention of post-transplant cardiac disease. We highlight areas of future research, including the need for goals and best medications for risk factors, the role of biomarkers, and the role of screening and intervention.
心血管疾病仍然是肾移植受者死亡和发病的主要原因，也是移植后住院的常见原因。存在几种传统和非传统的心血管危险因素，其中许多在移植前就存在，并且由于移植后免疫抑制的加入而部分恶化。我们讨论了这些危险因素的最佳识别和治疗策略，包括钠-葡萄糖共转运蛋白 2 抑制剂在移植后糖尿病和心血管疾病中的新作用。我们介绍了肾移植后常见的心血管疾病类型，包括冠状动脉疾病、心力衰竭、肺动脉高压、心律失常和瓣膜疾病。我们还讨论了移植后心脏疾病的筛查、治疗和预防。我们强调了未来研究的领域，包括确定危险因素的目标和最佳药物、生物标志物的作用以及筛查和干预的作用。
