Effects of statins on cardiovascular disease progression in renal transplant recipients

Abstract

The kidney transplantation is an effective treatment for Chronic Kidney Disease (CKD) patients, however the mortality rate within renal transplant recipients still high. Cardiovascular disease is the main cause of mortality in this population, several data point out that atherosclerotic disease is more aggressive in patients with kidney dysfunction when compared to general population. Coronary calcification, a marker of atherosclerosis, is a common feature in CKD patients. There are scarce data regarding the prevalence and associate factors of coronary artery calcification in renal transplant patients. Although a successful kidney transplant restore kidney function, which could contribute for decreasing progression of vascular calcification, patients after transplantation frequently had several atherogenic factors, such as hypertension, hyperglycemia, hyperlipidemia and obesity. Additionally, immunosuppression therapy, rejection, infection and inflammation episodes also contribute to the occurrence and progression of cardiovascular disease in this population. Of note, inflammation has been consistently reported in uremia and is associated with cardiovascular morbidity and mortality. Some studies demonstrated an association between inflammation and cardiovascular disease also in transplants recipients. The use of HMG-CoA reductase inhibitor is effective to normalize LDL-cholesterol in CKD patients and it seems to have also anti-inflammatory properties. ALERT study had demonstrated that a statin therapy could decrease the cholesterol levels and the occurrence of cardiovascular events in renal transplant recipients. Therefore the aim of this study is to evaluate the effects of Rosuvastatin® on cardiovascular disease progression in transplant recipients, especially through the progression of coronary calcification. (AU)