Studienarbeiten

Background

End-stage renal disease (ESRD), characterized by complete loss of renal function, is one of the leading causes of death worldwide, with cardiovascular mortality rates 10-20 times higher than in the general population¹. After transplantation, the risk is reduced to 3-5 times, but cardiovascular disease (CVD) is still the major cause of death in renal transplant recipients (RTRs), accounting for 40% to 55% of all deaths^2,3.

Therefore, it is critical for RTRs to predict risk of CVD, especially risk of major adverse cardiovascular events (MACE, defined as cerebrovascular events, myocardial infarction, cardiac arrest, heart failure and CV death). The effect of traditional CV risk factors such as aging, obesity, smoking, hypertension, diabetes mellitus, and dyslipidemia is well studied for general population and can be used for calculations in risk prediction^4,5. However, solely relying on traditional CV risk factors tends to underestimate the risk of MACE for RTRs. Nowadays, non-traditional factors are also gaining recognition for their roles in the progression of cardiac and renal dysfunctions in CKD, including renal impairment (reduced eGFR), proteinuria, inflammation, vascular calcifications, left ventricular hypertrophy, anemia, calcium phosphate imbalance, inhibition of nitric oxide synthesis, renin–angiotensin–aldosterone system (RAAS) activation⁶. In addition to the uremic milieu, the cardiovascular system of RTRs is also subjected to the metabolic adverse effects of immunosuppressive medications, and as a consequence of this, some traditional CVD risk factors seem to have different impact in RTRs compared with the general population. Accordingly, this project aims at identifying and quantifying the impact of risk factors with regards to MACE in RTRs.

Project Goal

The objective of project is to characterize the incidence and risk factors for MACE after kidney transplantation, aiming to find early markers for cardiovascular risk in ESRD patients and RTRs. This project is an observational study assessing predictors of post-operative MACE in patients enrolled in the STCS who underwent renal transplant surgery in the University Hospitals of Basel, Bern, Geneva, Lausanne, San Gallen and Zurich.

In this project, you will:

• Contribute a better understanding of the effect of cardiovascular risk factors in kidney transplant recipients
• Gain hands-on experience of the entire process of an observational study
• Have opportunity to visit Swiss transplant centers to collect clinical health records for kidney transplant patients
• Benefit from the collaboration within doctors and nurse practitioners

 You bring:

• Basic knowledge of medicine (ideally cardiology and nephrology)
• German or Swiss German proficiency
• The ability to work independently and reliably