Lee Jeonghwan, Chang Hong Suk, Mo Hyejin, Jung In Mok, Weon Boram, Kwon Soie, Lim Chun Soo, Kim Yon Su, Lee Sang-Ho, Lee Yu Ho, Lee Jeong-Hoon, Yang Jaeseok, Kim Myoung Soo, Lee Jung Pyo
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Kidney Res Clin Pract. 2025 Jul;44(4):679-692. doi: 10.23876/j.krcp.23.237. Epub 2024 Sep 13.
Cardiovascular disease is an important risk factor for mortality among kidney transplant recipients. In this study, we aimed to investigate the association between cardiovascular risk score at kidney transplantation and long-term outcomes of patients.
In this prospective, observational cohort study, we enrolled kidney transplant recipients who participated in the Korean Organ Transplantation Registry and underwent transplantation between April 2014 and December 2019. The cardiovascular risk status of kidney transplant recipients was assessed using the Framingham risk score. All-cause mortality, major adverse cardiovascular events, allograft failure, estimated glomerular filtration rates (eGFRs), and composite outcomes were evaluated after kidney transplantation.
Of the 4,682 kidney transplant recipients, 96 died during 30.7 ± 19.1 months of follow-up. The Kaplan-Meier survival analysis results showed that high Framingham risk scores were associated with all-cause mortality, major adverse cardiovascular events, and composite outcomes. According to the multivariable Cox analysis, high Framingham risk scores were associated with an increased risk of mortality (hazard ratio [HR], 3.20; 95% confidence interval [CI], 1.30-7.91), major adverse cardiovascular events (HR, 8.43; 95% CI, 2.41-29.52), and composite outcomes (HR, 2.05; 95% CI, 1.19-3.46). The eGFRs after transplantation were significantly higher among patients in the low Framingham risk score group (p < 0.001). However, Framingham risk scores were not associated with graft loss or rapid decline in eGFRs.
The Framingham risk score is a useful indicator of cardiovascular events, mortality, and kidney function after kidney transplantation.
心血管疾病是肾移植受者死亡的重要危险因素。在本研究中，我们旨在探讨肾移植时的心血管风险评分与患者长期预后之间的关联。
在这项前瞻性观察性队列研究中，我们纳入了参与韩国器官移植登记处且于2014年4月至2019年12月期间接受移植的肾移植受者。使用弗雷明汉风险评分评估肾移植受者的心血管风险状况。对肾移植后的全因死亡率、主要不良心血管事件、移植肾失功、估计肾小球滤过率（eGFR）和复合结局进行评估。
在4682例肾移植受者中，96例在30.7±19.1个月的随访期间死亡。卡普兰-迈耶生存分析结果显示，高弗雷明汉风险评分与全因死亡率、主要不良心血管事件和复合结局相关。根据多变量Cox分析，高弗雷明汉风险评分与死亡风险增加（风险比[HR]，3.20；95%置信区间[CI]，1.30 - 7.91）、主要不良心血管事件（HR，8.43；95%CI，2.41 - 29.52）和复合结局（HR，2.05；95%CI，1.19 - 3.46）相关。低弗雷明汉风险评分组患者移植后的eGFR显著更高（p < 0.001）。然而，弗雷明汉风险评分与移植肾丢失或eGFR快速下降无关。
弗雷明汉风险评分是肾移植后心血管事件、死亡率和肾功能的有用指标。
