Journal Article

Arterial stiffness and wave reflections in renal transplant recipients

Francis Verbeke, Wim Van Biesen, Patrick Peeters, Luc M. Van Bortel and Raymond C. Vanholder

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 22, issue 10, pages 3021-3027
Published in print October 2007 | ISSN: 0931-0509
Published online June 2007 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfm379
Arterial stiffness and wave reflections in renal transplant recipients

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Background. Arterial stiffness predicts cardiovascular disease (CVD) events and has been well documented in haemodialysis patients. Information in renal transplant recipients (RTR), however, remains limited despite their higher CVD risk compared to the general population. We aimed to assess arterial stiffening and wave reflections in RTR and healthy controls and to evaluate which factors could explain potential differences.

Methods. Carotid augmentation index (AI) and carotid-femoral pulse wave velocity (PWV) were measured in 200 RTR and 44 controls using applanation tonometry. The impact of traditional and non-traditional CVD risk factors was assessed using linear regression analysis. Glomerular filtration rate (GFR) was measured by 51Cr-EDTA (RTR) and estimated using the abbreviated Modification of Diet in Renal Disease formula (RTR and controls).

Results. After correction for age, blood pressure and anthropometry, AI and PWV remained 7.4 ± 3.6% (P = 0.04) and 0.7 ± 0.3 m/s (P = 0.01) higher in RTR than controls, corresponding to a difference in vascular age of >10 years. In multivariate analysis, additional independent factors related to AI and PWV were GFR (–1.8% and –0.19 m/s per 10 ml/min) and C-reactive protein (3.2% and 0.21 m/s per logarithm increase).

Conclusions. Increased arterial stiffness and wave reflections in RTR are attributable to incomplete restoration of GFR and the presence of subclinical inflammation.

Keywords: arterial stiffness; cardiovascular risk; inflammation; kidney function; kidney transplantation

Journal Article.  4187 words.  Illustrated.

Subjects: Nephrology

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