Hypothesis: Nontraditional risk factors, such as inflammation, vitamin D deficiency, elevated PTH, insulin resistance, homocysteine, or uric acid, contribute to cardiovascular disease progression after kidney transplant.

The purpose of this study is to evaluate which traditional and nontraditional cardiovascular disease risk factors best predict progression of cardiovascular disease (CVD) using carotid intima media thickness performed by ultrasound, in kidney transplant patients.

Cardiovascular disease remains the greatest cause of mortality after kidney transplant. Traditional risk factors, such as hypertension, diabetes, hyperlipidemia and smoking, contribute to vascular disease after transplant, but nontraditional risk factors may play a bigger role in vascular disease progression in this setting. This observational study will evaluate nontraditional risk factors for their contributions to vascular disease progression as determined by carotid intima media thickness and history of vascular disease events over time. The study requires annual checks of blood, urine, history, and carotid ultrasound for carotid intima media thickness

Inclusion Criteria:

• Kidney transplant more than 6 months ago
• 19 years or older

Exclusion Criteria:

• Estimated GFR <30
• Previous small bowel, or lung transplant
• Pancreas transplant less than 6 months ago
• Cancer or any condition that would change weight dramatically in the near future such as malabsorption.
• Willing to return for testing annually for 3 years
• Women who are pregnant

Transplant Clinic patients

3 years