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Research article
Progression of Endothelial Dysfunction, Atherosclerosis, and Arterial Stiffness in Stable Kidney Transplant Patients: A Pilot Study
Debasish Banerjee
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6863-2325
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Background: Kidney transplant patients suffer from vascular abnormalities and high cardiovascular event rates, despite initial improvements post-transplantation. The nature of the progression of vascular abnormalities in the longer term is unknown. This pilot study investigated changes in vascular abnormalities over time in stable kidney transplant patients long after transplantation. Methods: Brachial artery flow-mediated dilation (FMD), nitroglycerin-mediated dilation, carotid-femoral pulse wave velocity (cf-PWV), ankle-brachial pressure index, and common carotid artery intima-media thickness (CCA-IMT) were assessed in 18 kidney transplant patients and 17 controls at baseline and 3-6 months after. Results: There was no difference in age (51±13 vs. 46±11; P=0.19), body mass index (26±5 vs. 25±3; P=0.49), serum cholesterol (4.54±0.96 vs. 5.14±1.13; P=0.10), systolic blood pressure (BP) (132±12 vs. 126±12; P=0.13), diastolic BP (82±9 vs. 77±8; P=0.10), or diabetes status (3 vs. 0; P=0.08) between transplant patients and controls. No difference existed in vascular markers between patients and controls at baseline. In transplant patients, FMD decreased (-1.52±2.74; P=0.03), cf-PWV increased (0.62±1.06; P=0.03), and CCA-IMT increased (0.35±0.53; P=0.02). No changes were observed in controls. Conclusion: Markers of vascular structure and function worsen in the post-transplant period on long-term follow-up, which may explain the continued high cardiovascular event rates in this population. Key words: Endothelial function, arterial stiffness, atherosclerosis, kidney transplantation
Keywords
Endothelial function, arterial stiffness, atherosclerosis, kidney transplantation
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Received 04 Dec, 2019
Reviewer #5 agreed
On 02 Dec, 2019
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Reviewer #3 agreed
On 01 Dec, 2019
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On 01 Dec, 2019
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Received 01 Dec, 2019
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On 26 Nov, 2019
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On 25 Nov, 2019
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Editorial decision: Major revision
On 29 Oct, 2019
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Received 28 Oct, 2019
Review #4 received
Received 27 Oct, 2019
Review #3 received
Received 25 Oct, 2019
Review #6 received
Received 23 Oct, 2019
Review #5 received
Received 23 Oct, 2019
Reviewer #8 agreed
On 16 Oct, 2019
Reviewer #7 agreed
On 15 Oct, 2019
Review #2 received
Received 14 Oct, 2019
Review #1 received
Received 14 Oct, 2019
Reviewer #5 agreed
On 13 Oct, 2019
Reviewer #6 agreed
On 13 Oct, 2019
Reviewers invited
Invitations sent on 12 Oct, 2019
Reviewer #1 agreed
On 12 Oct, 2019
Reviewer #2 agreed
On 12 Oct, 2019
Reviewer #3 agreed
On 12 Oct, 2019
Reviewer #4 agreed
On 12 Oct, 2019
Editor assigned
On 10 Oct, 2019
Editor invited
On 09 Oct, 2019
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On 09 Oct, 2019
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Subject Areas
Cardiac & Cardiovascular Systems
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This preprint is under consideration at BMC Cardiovascular Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Progression of Endothelial Dysfunction, Atherosclerosis, and Arterial Stiffness in Stable Kidney Transplant Patients: A Pilot Study
Debasish Banerjee
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6863-2325
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 19 Dec, 2019
No community comments so far
Submission checks complete
On 12 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 10 Dec, 2019
Review #2 received
Received 07 Dec, 2019
Review #5 received
Received 04 Dec, 2019
Reviewer #5 agreed
On 02 Dec, 2019
Reviewers invited
Invitations sent on 01 Dec, 2019
Reviewer #1 agreed
On 01 Dec, 2019
Reviewer #2 agreed
On 01 Dec, 2019
Reviewer #3 agreed
On 01 Dec, 2019
Reviewer #4 agreed
On 01 Dec, 2019
Review #1 received
Received 01 Dec, 2019
Editor assigned
On 26 Nov, 2019
Submission checks complete
On 25 Nov, 2019
Editor invited
On 25 Nov, 2019
No comments provided
Editorial decision: Major revision
On 29 Oct, 2019
Review #7 received
Received 28 Oct, 2019
Review #4 received
Received 27 Oct, 2019
Review #3 received
Received 25 Oct, 2019
Review #6 received
Received 23 Oct, 2019
Review #5 received
Received 23 Oct, 2019
Reviewer #8 agreed
On 16 Oct, 2019
Reviewer #7 agreed
On 15 Oct, 2019
Review #2 received
Received 14 Oct, 2019
Review #1 received
Received 14 Oct, 2019
Reviewer #5 agreed
On 13 Oct, 2019
Reviewer #6 agreed
On 13 Oct, 2019
Reviewers invited
Invitations sent on 12 Oct, 2019
Reviewer #1 agreed
On 12 Oct, 2019
Reviewer #2 agreed
On 12 Oct, 2019
Reviewer #3 agreed
On 12 Oct, 2019
Reviewer #4 agreed
On 12 Oct, 2019
Editor assigned
On 10 Oct, 2019
Editor invited
On 09 Oct, 2019
Submission checks complete
On 09 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Kidney transplant patients suffer from vascular abnormalities and high cardiovascular event rates, despite initial improvements post-transplantation. The nature of the progression of vascular abnormalities in the longer term is unknown. This pilot study investigated changes in vascular abnormalities over time in stable kidney transplant patients long after transplantation. Methods: Brachial artery flow-mediated dilation (FMD), nitroglycerin-mediated dilation, carotid-femoral pulse wave velocity (cf-PWV), ankle-brachial pressure index, and common carotid artery intima-media thickness (CCA-IMT) were assessed in 18 kidney transplant patients and 17 controls at baseline and 3-6 months after. Results: There was no difference in age (51±13 vs. 46±11; P=0.19), body mass index (26±5 vs. 25±3; P=0.49), serum cholesterol (4.54±0.96 vs. 5.14±1.13; P=0.10), systolic blood pressure (BP) (132±12 vs. 126±12; P=0.13), diastolic BP (82±9 vs. 77±8; P=0.10), or diabetes status (3 vs. 0; P=0.08) between transplant patients and controls. No difference existed in vascular markers between patients and controls at baseline. In transplant patients, FMD decreased (-1.52±2.74; P=0.03), cf-PWV increased (0.62±1.06; P=0.03), and CCA-IMT increased (0.35±0.53; P=0.02). No changes were observed in controls. Conclusion: Markers of vascular structure and function worsen in the post-transplant period on long-term follow-up, which may explain the continued high cardiovascular event rates in this population. Key words: Endothelial function, arterial stiffness, atherosclerosis, kidney transplantation
Figure 1