Prospective Study of Changes in Arterial Stiffness among Kidney-Transplanted Patients

• Published in: Transplantation proceedings 2011-05, Vol.43 (4), p.1252-1253
• Main Authors: Kovács, D, Szabó, L, Fedor, R, Laczik, R, Soltész, P, Lőcsey, L, Asztalos, L
• Format: Article
• Language: English
• Subjects: Adult; Arteries - diagnostic imaging; Arteries - physiopathology; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Compliance; Cross-Sectional Studies; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Hungary; Immunosuppressive Agents - therapeutic use; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - surgery; Kidney Transplantation; Longitudinal Studies; Male; Medical sciences; Middle Aged; Peripheral Arterial Disease - diagnosis; Peripheral Arterial Disease - etiology; Peripheral Arterial Disease - physiopathology; Prospective Studies; Pulsatile Flow; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tissue, organ and graft immunology; Treatment Outcome; Ultrasonography; Upper Extremity - blood supply
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.03.074

Abstract Background Chronic kidney disease is one of the main risk factors for cardiovascular disease. Changes in stiffness parameters can predict the higher risk of the development of cardiovascular disease. Methods Cadaveric donor kidney transplant patients (n = 184) were followed in a cross-sectional single-center study. Arterial stiffness parameters were measured by arteriography. We analyzed the correlation between stiffness parameters and immunosuppressive therapy, the main operation parameters, patient age, elapsed time since transplantation, carotid artery stenosis, and septual wall thickness. We enrolled 24 patients in a 3-year longitudinal study to analyze changes in stiffness parameters. Results Our cross-sectional study showed pulse wave velocity (PWV) to be significantly related to the age of the patient ( P = .0001; r = 0.41). There was no significant correlation between the stiffness parameters and type or dosage of immunosuppressive drugs and number of transplantations. We noted significant correlations between pulse pressure (PP) and pulse wave velocity (PWV), and augmentation index (AI) ( P = .01). Patients with abnormal PWV (>12 m/s) showed significantly higher systolic blood pressures, body mass indexes, PP, and AI ( P < .01). Our 3-year longitudinal study revealed a significant elevation in PWV. Conclusions Improving endothelial function and prevention of atherosclerosis may help to reduce cardiovascular complications. Among chronic kidney disease patients, early transplantation is a possible way to prevent cardiovascular events. It is better to perform the transplantation at as early an age as possible.