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Use of cardioprotective medications in kidney transplant recipients.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2009 Aug; Vol. 9 (8), pp. 1811-5. Date of Electronic Publication: 2009 Jun 10. - Publication Year :
- 2009
-
Abstract
- Death with function causes half of late kidney transplant failures, and cardiovascular disease (CVD) is the most common cause of death in these patients. We examined the use of potentially cardioprotective medications in a prospective observational study at seven transplant centers in the United States and Canada. Among 935 patients, 87% received antihypertensive medications at both 1 and 6 months after transplantation. Similar antihypertensive regimens were used for patients with and without diabetes and CVD, but with wide variability among centers. In contrast, while 44% of patients were on angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) at the time of transplantation, the proportion taking these agents dropped to 12% at month 1, then increased to 24% at 6 months. Fewer than 30% with CVD or diabetes received ACEI/ARB therapy 6 months posttransplant. Aspirin use was uncommon (<40% of patients). Even among those with diabetes and/or CVD, fewer than 60% received aspirin and only half received a statin at 1 and 6 months. This study demonstrates marked variability in the use of cardioprotective medications in kidney transplant recipients, a finding that may reflect, among several possible explanations, clinical uncertainty due the lack of randomized trials for these medications in this population.
- Subjects :
- Adult
Angiotensin II Type 1 Receptor Blockers therapeutic use
Angiotensin-Converting Enzyme Inhibitors therapeutic use
Antihypertensive Agents therapeutic use
Aspirin therapeutic use
Canada
Cohort Studies
Cross-Sectional Studies
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Male
Middle Aged
Prospective Studies
United States
Cardiotonic Agents therapeutic use
Cardiovascular Diseases etiology
Cardiovascular Diseases prevention & control
Kidney Transplantation adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 9
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 19519808
- Full Text :
- https://doi.org/10.1111/j.1600-6143.2009.02696.x