Published online Dec 24, 2015. doi: 10.5500/wjt.v5.i4.222
Peer-review started: June 26, 2015
First decision: August 16, 2015
Revised: September 1, 2015
Accepted: November 13, 2015
Article in press: November 17, 2015
Published online: December 24, 2015
The development of end stage renal failure can be seen as a catastrophic health event and patients with this condition are considered at the highest risk of cardiovascular disease among any other patient groups and risk categories. Although kidney transplantation was hailed as an optimal solution to such devastating disease, many issues related to immune-suppressive drugs soon emerged and it became evident that cardiovascular disease would remain a vexing problem. Progression of chronic kidney disease is accompanied by profound alterations of mineral and bone metabolism that are believed to have an impact on the cardiovascular health of patients with advanced degrees of renal failure. Cardiovascular risk factors remain highly prevalent after kidney transplantation, some immune-suppression drugs worsen the risk profile of graft recipients and the alterations of mineral and bone metabolism seen in end stage renal failure are not completely resolved. Whether this complex situation promotes progression of vascular calcification, a hall-mark of advanced chronic kidney disease, and whether vascular calcifications contribute to the poor cardiovascular outcome of post-transplant patients is reviewed in this article.
Core tip: Despite partial restoration of glomerular function many bone and vascular abnormalities that develop during dialysis persist after kidney transplantation. Cardiovascular risk factors are also highly prevalent after kidney transplantation and some immune-suppressive drugs worsen the risk profile of graft recipients. As a result kidney transplant recipients continue to demonstrate a high cardiovascular risk in part due to the effect of vascular calcification.