In patients with kidney transplant is essential to improve the cardiovascular risk profile.

-cardiovascular disease, more specifically the coronary heart disease is the leading cause of death of patients

-the classical cardiovascular risk factors (hypertension)(, Hyperlipidemia, diabetes, and obesity), boosted by some aspects specific to kidney transplantation (the status of renal failure and the use of immunosuppressive drugs), are the real culprits that kidney transplanted patients suffering cardiovascular events that threaten his life

– early intervention (before transplantation) and comprehensive management of transplanted patients, they are the best weapons to improve the quality of life and reduce the mortality of cardiovascular origin in these patients

Seville, October of 2011- renal diseases are directly related to cardiovascular diseases. Thus, the classical cardiovascular risk factors (diabetes, hypertension, obesity, cholesterol, tobacco, etc.) are also risk factors for kidney patients

the relationship between the kidney and heart is essential, because kidney disease is part of the cardiovascular and vice versa. Chronic kidney disease (ERC) is a risk factor for the cardiac patients with heart failure, coronary artery disease, heart attack, etc. Similarly, it is proven that the kidney patient has 95% of hypertension cases, 85% Cardiac involvement and 53 per cent die with ERC.

According to Dr. José María Morales, nephrologist of the 12 of October in Madrid Hospital, cardiovascular disease, more specifically the coronary heart disease is the leading cause of death of our patients. Therefore, in patients with kidney transplant is essential to improve the cardiovascular risk profile ”.

While there has been optimizing Kidney Graft short-term survival, improving the surgical technique with the emergence of new immunosuppressive drugs, transplanted kidney’s long-term survival has not improved substantially, due, among other factors, the rate of cardiovascular mortality in renal transplanted patients.

Classical cardiovascular risk factors (hypertension, hiperlemia, diabetes and obesity), powered by some specific aspects of kidney transplantation (the status of renal failure and the use of immunosuppressive drugs), are the real culprits that kidney transplanted patients suffering cardiovascular events that threaten his life ”, points out Dr. Morales.

In addition, kidney transplantation outcomes have improved in recent years in Spain chronic nephropathy of graft and the death of the patient with a functioning transplant to be the two main causes of loss of graft ”.

Therefore, the early intervention (before transplantation) and a comprehensive medical approach of transplanted patients are suitable weapons to improve the quality of life and reduce the mortality of cardiovascular origin in this patient ”, stresses.

Immunosuppressive Protocol

The fundamental objective of the currently used immunosuppressive therapy is to prevent the rejection of the graft trying to avoid, at the same time, the infectious and neoplastic morbidity associated with the on immunosuppression.

The most widely used immunosuppressant Protocol consists of triple therapy with steroids, tacrolimus (delayed release tacrolimus) and mycophenolate mofetil / acid micofenolico. According to Dr. Morales, the effectiveness of this combination is excellent although patients may have greater or lesser extent diabetes of novo, Hyperlipidemia and hypertension (hypertension) ”.

The withdrawal of steroid and adjustment of tacrolimus levels improve these complications. The inhibitors m-TOR improve renal function but induce hypocaloric, although is not proved conducive to the development of coronary heart disease.

In this sense, in heart transplant patients used successfully since it decreases the graft vascular disease. Belatacept is a new immunosuppressant, inhibitor drug of the coestimuladora track, which has shown similar efficacy to CyA-based regimes. In addition, it has no effect nefrotoxico or influences the development of hypertension, diabetes or hypocaloric. Therefore, the possible combinations with Belatacept can improve cardiovascular profile post-transplant and perhaps reduce serious cardiovascular complications and mortality post-transplant ”, concludes Dr. Morales.

The Spanish society of Nephrology

The Spanish society of Nephrology is a scientific society whose objectives are to promote and disseminate scientific and advances clinical in the field of specialty, covering fields as diverse as high blood pressure, kidney disease, the progression of renal insufficiency, or renal dialysis (hemodialysis or peritoneal dialysis) or kidney transplant replacement therapy when the renal function does not allow the survival of the patient. It also promotes research on extra kidney complications of kidney disease (anemia, bone disorders, cardiovascular complications, etc.). It currently has 1,700 members between researchers and clinical Nephrologists on topics related to the specialty. This company organizes a Conference, as well as several refresher courses throughout the year, both for specialists and resident doctors.