5. Conclusion

Cardiovascular disease is the leading cause of death in patients with a transplanted kidney. The incidence of cardiovascular disease in patients with a transplanted kidney is 3–5 times higher than in the general population. Risk factors for the development of cardiovascular diseases in patients with a transplanted kidney are divided into traditional and nontraditional. Traditional risk factors: immutable (age, gender, inheritance), variable (smoking, hyperlipidemia, hypertension, obesity, diabetes mellitus, physical activity, stress). Nontraditional risk factors: risk factors related to the status of transplantation and its treatment (immunosuppressive agents, graft rejection, viral infection - cytomegalovirus) and risk factors associated with chronic regression in allograft function (anemia, volume load, hyperhomocysteinemia, oxidative stress, secondary hyperparathyroidism, microinflammation). The most common cardiovascular diseases in patients after kidney transplantation are as follows: ischemic heart disease, congestive heart failure and left ventricular hypertrophy. Of all cardiovascular complications, ischemic heart disease is by far the most common cause of mortality (more than 50%) in patients with a transplanted kidney. Frequency of left ventricular hypertrophy ranges from 50 to 70% in patients with a transplanted kidney. The incidence of congestive heart failure in patients with a transplanted kidney is 2–5 times higher than the incidence in the general population. The incidence of congestive heart failure in patients with a transplanted kidney was 10.2% 12 months after transplantation and 18.3% 36 months after transplantation. The risk assessment of cardiovascular disease in asymptomatic patients with a transplanted kidney is of great practical importance because it allows the identification of patients at high risk for cardiovascular events, which further allows timely intervention before the disease develops. To assess the risk of cardiovascular disease in asymptomatic patients with a transplanted kidney, we can apply the scores used for assessment of cardiovascular risk in general population. Several studies have shown that the use of standard scores in the assessment of the degree of risk of cardiovascular disease in patients with renal disease is insufficient. It is recommended that standard risk factors be enhanced with additional risk factors (e.g., homocystein, Creactive protein). Additional risk factors are recommended for increasing the precision of risk assessment. Assessing the patient's risk of developing cardiovascular disease enables the identification of patients at high risk for the development of cardiovascular events, which allow the intervention before the disease develops.
