Correlates of Atherosclerotic Vascular Disease in Stable Postrenal Transplant Patients from South India

Introduction: Renal transplant recipients (RTRs) show increased mortality after 1st year of undergoing renal transplantation. Cardiovascular disease (CVD) is the major cause of mortality in these patients. Oxidative stress (OS), in.ammation, and endothelial dysfunction (ED) represent a key triad for the onset and progression of atherosclerosis. The present study was undertaken to assess OS, inflammatory biomarkers, and ED as a surrogate marker of atherosclerosis in stable RTRs. Materials and Methods: Thirty stable post-RTRs along with 30 healthy individuals as controls were included in the study conducted at a tertiary care teaching hospital in south India. Lipid profile; OS markers; malondialdehyde (MDA), ischemia-modified albumin (IMA), and ferric reducing ability of plasma (FRAP); inflammatory marker high-sensitivity C-reactive protein and interleukin 6 (IL-6); ED markers nitric oxide (NO) and P-selectin were estimated using standard methods. Lipid indices were calculated. Carotid intima-media thickness, two-dimensional echocardiogram, and renal Doppler scans were done. Results: No difference in lipid profile was observed between the RTRs and the control groups. RTRs had significantly higher oxidant markers (MDA and IMA), inflammatory marker (IL-6), marker of ED (NO), and lower antioxidant marker (FRAP) (P < 0.05) compared to the control group. RTRs had significantly more number of carotid plaques compared to the control group. A positive correlation was observed between number of carotid plaque and OS, ED, and inflammatory markers. Conclusion: RTRs have increased CVD risk despite undergoing renal replacement therapy. This can be attributed to the increased OS and inflammation which is seen in these patients.