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Use of cardioprotective medications in kidney transplant recipients.
Gaston, R S; Kasiske, B L; Fieberg, A M; Leduc, R; Cosio, F C; Gourishankar, S; Halloran, P; Hunsicker, L; Rush, D; Matas, A J.
Afiliación
  • Gaston RS; University of Alabama at Birmingham, Birmingham, AL, USA. rgaston@uab.edu
Am J Transplant ; 9(8): 1811-5, 2009 Aug.
Article en En | MEDLINE | ID: mdl-19519808
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.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cardiotónicos / Enfermedades Cardiovasculares / Trasplante de Riñón Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2009 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cardiotónicos / Enfermedades Cardiovasculares / Trasplante de Riñón Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2009 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos