Dear Editor,
We intentionally read the article “The Relationship between Oxidative Stress, Inflammation, and Atherosclerosis in Renal Transplant and End-Stage Renal Disease Patients” written by Turkmen et al. with great interest.Citation1 They concluded that in patients with end-stage renal failure who are on hemodialysis or peritoneal dialysis, but in a smaller amount, there has been ongoing inflammation and increased risk of atherosclerosis in post-renal transplantation period. The study is well planned and the results are well presented. We believe that these findings will enlighten further studies on renal transplantation and atherosclerosis. We thank the authors for their contribution.
As we know, in many aspects such as costs and survival, renal transplantation is still the best treatment for end-stage renal failure. It should be done to any end-stage renal failure patient whenever possible.Citation2 In light of the present study, we do think that renal transplantation patients suffer from adverse conditions like ongoing atherosclerosis, though in smaller amount, because of the side effects of the medication used for the immunosuppressive purpose. In accordance with the study carried out in this article, the patients may suffer from newly onset hypertension, newly onset diabetes or hyperlipidemia after the transplantation period because of the drugs they regularly have to take, although they do not have these disorders before. These disorders are known to increase endothelial dysfunction and levels of inflammatory markers. We do think that as the immunosuppressive treatment options are improved with time, these patients will benefit more from renal transplantation and risks will decline.
In addition, smoking affects the endothelial function and patients who smoke have atherosclerotic disease more than non-smoking population.Citation3 We think that it might be more helpful if the authors gave information about patients’ smoking habits.
Mustafa Cakar
Department of Internal Medicine, Gulhane Military Medical Academy, Ankara, Turkey
E-mail: [email protected]
Murat Karaman
Department of Internal Medicine, Gulhane Military Medical Academy, Ankara, Turkey
E-mail: [email protected]
Seyit Ahmet Ay
Department of Internal Medicine, Gulhane Medical Academy, Ankara, Turkey
E-mail: [email protected]
Sevket Balta
Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
E-mail: [email protected]
Sait Demirkol
Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
E-mail: [email protected]
References
- Turkmen K, Tonbul HZ, Toker A, The relationship between oxidative stress, inflammation, and atherosclerosis in renal transplant and end-stage renal disease patients. Ren Fail. 2012;34(10):1229–1237.
- Brown W, McDermott J, Figueiredo AE, Loucaidou M, Galliford J, Papalois V. Improving access to kidney transplant information has increased preemptive living kidney donation. Ren Fail. 2011;33(7):658–662.
- Cerne D, Kaplan-Pavlovcic S, Kranjec I, Jurgens G. Mildly elevated serum creatinine concentration correlates with the extent of coronary atherosclerosis. Ren Fail. 2000;22(6):799–808.