Advances in TransplantologyKidney transplantationPrediction of Cardiovascular Events After Renal Transplantation
Section snippets
Study Population and Protocol
Patients were recruited at the transplantation center of a university hospital at Berlin, Germany (Charité – Campus Benjamin Franklin). For reasons of comparability of pulse wave analysis, bilateral fistula was regarded as an exclusion criterion. Inclusion criteria were written informed consent for participation and renal transplantation ≥3 months ago with a functioning graft. Transplantation <3 months ago was defined as an exclusion criterion because we have previously shown that changes in
Results
Sixty-four patients were enrolled in the study. Epidemiological information, data on transplantation and graft function, cause of ESRD, concomitant diseases, and traditional cardiovascular risk factors are presented in Table 1. Median age was 52 years (interquartile range, 42.5–61). Patients were on dialysis for a median of 64 months (interquartile range, 24–84.5) and the median post-transplantation period was 96 months (interquartile range, 60–165). The predominant cause of ESRD was
Discussion
Arterial stiffness reflects the extent of arteriosclerosis and is an independent predictor of CVE in both the general population and the dialysis population. To date, it remained elusive whether pulse wave analysis can be used to assess cardiovascular risk after renal transplantation as well. The present study shows for the first time that PWV is indeed an independent predictor of fatal and nonfatal CVE in renal allograft recipients. PWV was significantly higher in those patients suffering from
Acknowledgment
We would like to thank Mrs Simone Voigt for her unfailing support in our research.
References (37)
- et al.
Long-term survival in renal transplant recipients with graft function
Kidney Int
(2000) - et al.
Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis
J Am Coll Cardiol
(2010) - et al.
Aortic pulse wave velocity index and mortality in end-stage renal disease
Kidney Int
(2003) - et al.
Lack of improvement in renal allograft survival despite a marked decrease in acute rejection rates over the most recent era
Am J Transplant
(2004) - et al.
Arterial function after successful renal transplantation
Kidney Int
(2004) - et al.
Impaired renal allograft function is associated with increased arterial stiffness in renal transplant recipients
Am J Transplant
(2006) - et al.
Cardiovascular events following renal transplantation: role of traditional and transplant-specific risk factors
Kidney Int
(2006) - et al.
Central aortic pressure augmentation in stable renal transplant recipients
Kidney Int
(2002) Epidemiology of cardiovascular disease after renal transplantation
Transplantation
(2001)- et al.
Risk factors for cardiovascular disease in renal transplant recipients and strategies to minimize risk
Transplant Int
(2010)
ACCF/AHA clinical practice guideline methodology summit report: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Circulation
Impact of aortic stiffness on survival in end-stage renal disease
Circulation
Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients
Hypertension
Arterial wave reflections and survival in end-stage renal failure
Hypertension
Time-dependent effects of cadaveric renal transplantation on arterial compliance in patients with end-stage renal disease
Transplantation
Differential effects of cyclosporine and tacrolimus on arterial function
Transplant Int
The impact of FTY720 (fingolimod) on vasodilatory function and arterial elasticity in renal transplant patients
Nephrol Dial Transplant
Central blood pressure measurements and antihypertensive therapy: a consensus document
Hypertension
Cited by (14)
Aerobic or resistance training and pulse wave velocity in kidney transplant recipients: A 12-week pilot randomized controlled trial (the Exercise in Renal Transplant [ExeRT] Trial)
2015, American Journal of Kidney DiseasesCitation Excerpt :The association of higher heart rate at rest and higher PWV measurement has been suggested in several studies,41-43 including the potentially unfavorable effect of calcineurin inhibitors on heart rate at rest44 and PWV.45 The acute influence of calcineurin inhibitor levels on arterial elasticity has also been postulated.46 Although PWV was measured at the same time of day, individual patient calcineurin inhibitor ingestion time was not monitored.
Comparative Analysis of Arterial Stiffness and Body Composition in Early and Late Periods After Kidney Transplantation
2018, Transplantation ProceedingsCitation Excerpt :It has been demonstrated that dyslipidemia, increased total cholesterol, LDL, and triglycerides lead to increased arterial stiffness and thus accelerate the occurrence of atherosclerosis. Seibert et al [7] conducted studies on the occurrence of CVD in patients after KTx and found that PWV was the only significant statistical parameter associated with the cardiovascular events (10.1 ± 3.6 m/s vs 8.5 ± 1.5 m/s, P = .048). Parameters such as aortic systolic pressure (115 ± 28 vs 118.7 mm Hg, P = .635), SBP (130.5 ± 29.9 mm Hg vs 131.7 ± 17 mm Hg, P = .408), and pulse (62.3 ± 17.3 mm Hg vs 56.8 ± 12.1 mm Hg, P = .128) showed no significant correlation.
24-hour Arterial Stiffness Monitoring in Kidney Transplant Recipients in the Early Postoperative Period
2018, Transplantation ProceedingsCitation Excerpt :The authors demonstrated higher BMI values and higher serum calcium levels to be independent risk factors affecting the post-transplantation PWV value. Seibert et al [13] conducted studies on the incidence of CVEs in KTx patients and demonstrated that PWV was the only statistically significant measure associated with CVEs in KTx recipients (PWV of 10.1 ± 3.6 m/s in patients who developed a predefined CVE vs 8.5 ± 1.5 m/s in those who did not; P = .048). No significant correlation was shown for such parameters as aortic SBP (115 ± 28 vs 118.7 mm Hg; P = .635), peripheral SBP (130.5 ± 29.9 vs 131.7 ± 17 mm Hg; P = .408), or PP (62.3 ± 17.3 vs 56.8 ± 12.1 mm Hg; P = .128).
Changes in AZGP1 Serum Levels and Correlation With Pulse Wave Velocity After Kidney Transplantation
2021, Frontiers in Cardiovascular Medicine