European best practice guidelines for renal transplantation. Section IV: Long-term management of the transplant recipient. IV.5.1. Cardiovascular risks. Cardiovascular disease after renal transplantation.

A. Post-transplant cardiovascular disease is very common, an important cause of morbidity and the first cause of mortality in renal transplant recipients. Therefore, detection and early treatment of post-transplant cardiovascular disease are mandatory. B. Specific risk factors for developing post-transplant cardiovascular disease include pre-transplant cardiovascular disease, arterial hypertension, uraemia (graft dysfunction), hyperlipidaemia, diabetes mellitus, smoking and immunosuppressive treatment. These factors should be targeted for intervention. C. Pre-transplant cardiovascular disease is a major risk factor for post-transplant cardiovascular disease. Therefore, prior to transplantation, it is mandatory to detect and treat symptomatic coronary artery disease, heart failure due to valvular failure or cardiomyopathy, and pericardial constriction. This policy should also be followed in asymptomatic diabetic patients.