COMPLICATIONS - CARDIOVASCULAR

H. Pilmore¹, B. Kasiske², A. Israni³, M. Skeans⁴, J. Snyder^5
1Auckland City Hospital, Department of Renal Medicine, Auckland/NEW ZEALAND, ², University of Minnesota, Minneapolis/UNITED STATES OF AMERICA, ³Medicine, Hennepin County Medical Center, Minneapolis/UNITED STATES OF AMERICA, ⁴Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis/UNITED STATES OF AMERICA, ⁵Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis/MN/UNITED STATES OF AMERICA

Body: Introduction: Cardiovascular Disease is the most common cause of mortality and morbidity after renal transplantation. Despite the high rates of cardiovascular events in renal transplant recipients, there are few studies examining the effects of cardiovascular medications and these data have largely been limited to the use of statins. PORT is the largest multi-center, international collection of non-immunosuppressive medication data in existence in the renal transplant population. This study aimed to examine the use of cardiovascular medications after renal transplantation. Methods: The study population included all adult kidney transplant recipients with graft function 30 days post-transplant from a subset of the 14 participating transplant centers. 10 of 14 centers provided data on use of beta-blockers, ACEIs/ARBs, calcium channel blockers, antiplatelets, diuretics, other antihypertensive drugs and lipid lowering agents including statins (N=14,236). Medication use was defined as using the medication at any time during each 30-day period post-transplant. Results: There was a significant increase in the use of all CVS medications from 1990 – 2006 (Figure 1). This was most marked in the use of statins from 2000 – 2006 (OR 12.60) however the use of all classes of CVS medications increased with the exception of diuretics. In a logistic regression, transplantation between 2000 – 2006 was the most significant factor associated with CVS medication use. Despite increased use of both Statins and LLA in patients with CVS co-morbidity prior to transplantation, use at 4 months is still lower than expected (Figure 2) with less than 50% of patients with a history of DM using statins. Similarly, the use of Aspirin and Beta Blockers, while increased in those with CVS risk factors, was lower than expected. The use of ACE/ARBs was low in all groups with no increase in use in patients at high CVS risk. Conclusions:This is the first study to describe the use of CVS in a large multi-center international group of renal transplant recipients and to correlate use with cardiovascular risk.

Disclosure: All authors have declared no conflicts of interest.