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assessment is based on the following risk factors: age, sex, smoking, systolic blood pressure, total cholesterol, or cholesterol/HDL ratio. A high risk threshold based on a fatal cardiovascu-

Early detection of high-risk patients for the development of cardiovascular diseases allows timely application of an appropriate therapeutic strategy that ensures high survival rates for

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. In asymptomatic patients, cardiovascular risk assessment should be carried out and preventive activates should be performed accordingly. Patients with established multifactorial risk should be subjected to preventive activities, and, if necessary to

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 [54]. In these scores, we use the following data: age, gender, blood pressure, lipid level, without taking into account

Nontraditional risk factors that are not included in these scores can play an important role in the insufficient assessment of the risk of cardiovascular disease in patients with a transplanted kidney. All these point should be consider by creating a new risk score that would include both traditional and nontraditional risk factors for cardiovascular disease. It is recommended that standard risk factors be enhanced with additional risk factors (e.g., homocystein, C-reactive protein). Additional risk factors are recommended for increasing the precision of risk assess-

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

nontraditional risk factors for occurrence of cardiovascular diseases.

lar outcome is defined as more than or equal to 5%.

326 Organ Donation and Transplantation - Current Status and Future Challenges

patients with a transplanted kidney (Table 1).

medication therapy.

ment.

5. Conclusion

Daniela Loncar and Selma Hodzic\*

\*Address all correspondence to: hodzic\_selma@live.com

Clinic for Internal Disease, University Clinical Center Tuzla, Bosnia and Herzegovina
