Cardiovascular disease risk factors and lifestyle modification strategies after pediatric kidney transplantation: what are we dealing with, and what can we target?
Se Ri BaeAlexandra C BickiSarah CoufalEthan JinElaine KuPublished in: Pediatric nephrology (Berlin, Germany) (2022)
Kidney transplantation in pediatric patients can lead to partial improvement of some of the cardiometabolic parameters that increase the risk for cardiovascular disease (CVD) in patients with chronic kidney disease. However, even after restoration of kidney function, transplant recipients remain at risk for CVD due to the continual presence of traditional and non-traditional risk factors, including the side effects of immunosuppression and chronic inflammation. This educational review describes the prevalence of CVD risk factors in pediatric kidney transplant recipients and presents available evidence for therapeutic lifestyle changes and other non-pharmacologic strategies that can be used to improve traditional and modifiable CVD risk factors. Although trial-grade evidence for interventions that improve CVD in pediatric kidney transplant recipients is limited, potential strategies include lowering dietary sodium and saturated fat intake and increasing physical activity levels. Intensive follow-up may help patients achieve guideline-recommended goals for reducing their overall CVD risk.
Keyphrases
- risk factors
- kidney transplantation
- cardiovascular disease
- physical activity
- end stage renal disease
- metabolic syndrome
- type diabetes
- weight loss
- oxidative stress
- newly diagnosed
- body mass index
- chronic kidney disease
- prognostic factors
- study protocol
- coronary artery disease
- public health
- peritoneal dialysis
- risk assessment
- patient reported outcomes
- cardiovascular events
- young adults
- double blind