Belal AA, Santos Jr AH, Kazory A. Non-traditional cardiovascular risk factors after kidney transplantation. World J Nephrol 2025; 14(4): 110896 [DOI: 10.5527/wjn.v14.i4.110896]
Corresponding Author of This Article
Amer Ashaab Belal, MD, Assistant Professor, FASN, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida College of Medicine, 1600 SW Archer Road, Room CG-98, Communicore Building, Gainesville, FL 32610, United States. abelal@ufl.edu
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Dec 25, 2025; 14(4): 110896 Published online Dec 25, 2025. doi: 10.5527/wjn.v14.i4.110896
Non-traditional cardiovascular risk factors after kidney transplantation
Amer Ashaab Belal, Alfonso H Santos Jr, Amir Kazory
Amer Ashaab Belal, Alfonso H Santos Jr, Amir Kazory, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida College of Medicine, Gainesville, FL 32610, United States
Author contributions: Belal AA contributed to conception and design of the work, leading the writing of the original draft, literature review, critical revision and editing, and approval of the final version of the manuscript; Santos Jr AH contributed to the literature review, writing, revision and approval of the final version of the manuscript; Kazory A contributed to the critical revision, editing, and approval of the final version of the manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amer Ashaab Belal, MD, Assistant Professor, FASN, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida College of Medicine, 1600 SW Archer Road, Room CG-98, Communicore Building, Gainesville, FL 32610, United States. abelal@ufl.edu
Received: June 18, 2025 Revised: July 7, 2025 Accepted: October 11, 2025 Published online: December 25, 2025 Processing time: 188 Days and 16.2 Hours
Abstract
Kidney transplantation remains the best treatment option for patients with end-stage kidney disease, offering superior outcomes and improved quality of life. However, as in the general population, cardiovascular disease remains the leading cause of mortality among kidney transplant recipients. While traditional cardiovascular risk factors—such as hypertension, diabetes, dyslipidemia, and tobacco use—are prevalent in this population, they are often compounded by transplant-specific and non-traditional risk factors unique to the post-transplant setting. This review aims to explore these non-traditional and transplant-related cardiovascular risk factors, including allograft dysfunction and acute rejection episodes. Moreover, we will provide an overview of the cardiovascular implications of immunosuppressive therapy, including its association with opportunistic infections such as cytomegalovirus. Finally, we will touch upon considerations for special populations of kidney transplant recipients based on our current understanding of these non-traditional cardiovascular risks with the currently available data.
Core Tip: Kidney transplantation offers improved quality of life and survival advantages in addition to a reduced cardiovascular disease risk overall compared to remaining on long-term dialysis. However, kidney transplant recipients continue to experience a higher risk of adverse cardiovascular disease outcomes compared to the general population, with many of these risk factors worsened by and specific to their transplant.
