Impaired Microvascular Reactivity in Patients with Chronic Kidney Disease Submitted to Kidney Transplantation: A Prospective Observational Study

The effect of kidney transplantation on endothelial dysfunction and autonomic dysfunction in uremia remains controversial, and few studies have evaluated this question. Endothelial dysfunction and autonomic dysfunction, both, be assessed noninvasively using laser Doppler flowmetry (LDF). This study...

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Published in:Kidney & blood pressure research 2024-01, Vol.49 (1), p.619-629
Main Authors: Borges, Paulo Sergio, Orange, Flavia Augusta, Pontes, Isabelle Albuquerque, Clough, Geraldine F, Alves, João Guilherme Bezerra
Format: Article
Language:English
Subjects:
Adult
chronic kidney disease
endothelial function
Female
Humans
Kidney Transplantation
Laser-Doppler Flowmetry
Longitudinal Studies
Male
Microcirculation
Middle Aged
Prospective Studies
Renal Insufficiency, Chronic - physiopathology
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Summary:The effect of kidney transplantation on endothelial dysfunction and autonomic dysfunction in uremia remains controversial, and few studies have evaluated this question. Endothelial dysfunction and autonomic dysfunction, both, be assessed noninvasively using laser Doppler flowmetry (LDF). This study evaluated cutaneous microvascular blood flow and reactivity using LDF in patients undergoing kidney transplantation. This prospective longitudinal cohort study involved 40 patients with chronic kidney disease (CKD) undergoing kidney transplantation, compared with 40 patients without kidney disease. Using LDF, post-occlusive reactive hyperemia (PORH) (resting flow [RF], peak flow, ratio between peak, and RF, hyperemic area, PORH index), and sympathetic constrictor response to inspiratory breath-hold (mean minimum inspiratory values) were evaluated. RF and sympathetic constrictor response to inspiratory breath-hold (mean minimum inspiratory values), were lower in the CKD group at 1 week and at 3 months after transplantation (p < 0.005). Mean minimum inspiratory values increase in the CKD group, 3 months after transplantation. Compared with controls with no CKD, in CKD patients undergoing kidney transplantation, microcirculation by LDF shows improvement after 3 months.
ISSN:1420-4096
1423-0143
1423-0143
DOI:10.1159/000540047