Progression of Endothelial Dysfunction, Atherosclerosis, and Arterial Stiffness in Stable Kidney Transplant Patients: A Pilot Study
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
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Posted 19 Dec, 2019
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On 12 Oct, 2019
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On 09 Oct, 2019
Progression of Endothelial Dysfunction, Atherosclerosis, and Arterial Stiffness in Stable Kidney Transplant Patients: A Pilot Study
Posted 19 Dec, 2019
On 12 Dec, 2019
On 10 Dec, 2019
Received 07 Dec, 2019
Received 04 Dec, 2019
On 02 Dec, 2019
Invitations sent on 01 Dec, 2019
On 01 Dec, 2019
On 01 Dec, 2019
On 01 Dec, 2019
On 01 Dec, 2019
Received 01 Dec, 2019
On 26 Nov, 2019
On 25 Nov, 2019
On 25 Nov, 2019
On 29 Oct, 2019
Received 28 Oct, 2019
Received 27 Oct, 2019
Received 25 Oct, 2019
Received 23 Oct, 2019
Received 23 Oct, 2019
On 16 Oct, 2019
On 15 Oct, 2019
Received 14 Oct, 2019
Received 14 Oct, 2019
On 13 Oct, 2019
On 13 Oct, 2019
Invitations sent on 12 Oct, 2019
On 12 Oct, 2019
On 12 Oct, 2019
On 12 Oct, 2019
On 12 Oct, 2019
On 10 Oct, 2019
On 09 Oct, 2019
On 09 Oct, 2019
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