Peripheral Vascular Disease and Kidney Transplant Outcomes: Rethinking an Important Ongoing Complication
- 2 November 2020
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 105 (6), 1188-1202
- https://doi.org/10.1097/tp.0000000000003518
Abstract
Peripheral vascular disease (PVD) is highly prevalent in patients on the waiting list for kidney transplantation (KT) and after transplantation and is associated with impaired transplant outcomes. Multiple traditional and non-traditional risk factors, as well as uremia- and transplant-related factors, affect two processes that can coexist, atherosclerosis and arteriosclerosis, leading to PVD. Some pathogenic mechanisms, such as inflammation-related endothelial dysfunction, mineral metabolism disorders, lipid alterations, or diabetic status, may contribute to the development and progression of PVD. Early detection of PVD before and after KT, better understanding of the mechanisms of vascular damage, and application of suitable therapeutic approaches could all minimize the impact of PVD on transplant outcomes. This review focuses on the following issues: a) definition, epidemiological data, diagnosis, risk factors and pathogenic mechanisms in KT candidates and recipients; b) adverse clinical consequences and outcomes; and c) classical and new therapeutic approachesThis publication has 138 references indexed in Scilit:
- Exercise capacity is the strongest predictor of mortality in patients with peripheral arterial diseaseJournal of Vascular Surgery, 2013
- Type 1 Diabetes Increases the Expression of Proinflammatory Cytokines and Adhesion Molecules in the Artery Wall of Candidate Patients for Kidney TransplantationDiabetes Care, 2012
- Gene expression profiling of peripheral blood mononuclear cells in the setting of peripheral arterial diseaseJournal of Clinical Bioinformatics, 2012
- Effect of fibroblast growth factor NV1FGF on amputation and death: a randomised placebo-controlled trial of gene therapy in critical limb ischaemiaThe Lancet, 2011
- Predicting Six-Month Mortality for Patients Who Are on Maintenance HemodialysisClinical Journal of the American Society of Nephrology, 2010
- Complex Regulation and Function of the Inflammatory Smooth Muscle Cell Phenotype in AtherosclerosisJournal of Vascular Research, 2009
- A Novel Risk Score for Mortality in Renal Transplant Recipients Beyond the First Posttransplant YearTransplantation, 2009
- Half of Kidney Transplant Candidates Who Are Older than 60 Years Now Placed on the Waiting List Will Die before Receiving a Deceased-Donor TransplantClinical Journal of the American Society of Nephrology, 2009
- siRNA silencing reveals role of vascular cell adhesion molecule-1 in vascular smooth muscle cell migrationAtherosclerosis, 2008
- Evidence of Increased Inflammation and Microcirculatory Abnormalities in Patients With Type 1 Diabetes and Their Role in Microvascular ComplicationsDiabetes, 2007