Cardiovascular (CV) disease is the most common cause of mortality among kidney transplant candidates on the
waiting-list and after kidney transplantation. The mechanisms of cardiovascular disease burden after transplant are
multifactorial and the risk is largely determined by pre-transplant factors including CV disease and dialysis duration.
Current pre-transplant cardiac evaluation protocols have proven to be inconsistent in predicting adverse cardiovascular
outcome post-transplant. However, multiple biomarkers have been recognized as predictors of all-cause mortality and
cardiovascular events including graft function, hemoglobin, homocysteine, C - reactive protein among others. Of these,
elevation in the biomarker cardiac troponin T appears to be a significant predictor of cardiovascular events and mortality
among wait-listed kidney transplant candidates and after transplantation. The relationship between CV risk reduction,
normalization of cardiac troponin T levels and restoration of renal function after kidney transplant is complex but opens
opportunities for the use of cardiac troponin T and other cardiovascular biomarkers as important endpoints of clinical
interventions in kidney transplant recipients.