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NDT Advance Access published online on June 27, 2007
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfm379
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Arterial stiffness and wave reflections in renal transplant recipients

Francis Verbeke1, Wim Van Biesen1, Patrick Peeters1, Luc M. Van Bortel2 and Raymond C. Vanholder1

1Ghent University Hospital, Nephrology section, Department of Internal Medicine and 2Ghent University, Heymans Institute of Pharmacology, De Pintelaan 185, 9000 Gent, Belgium

Correspondence and offprint requests to: Francis Verbeke, University Hospital Ghent, Department of Internal Medicine, Nephrology section, De Pintelaan 185 B-9000 Gent, Belgium. Email: francis.verbeke{at}UGent.be



  Abstract

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

1The authors wish it to be known that, in their opinion, F.V. is the first author to this work.

Received for publication: 11. 4.07
Accepted in revised form: 22. 5.07


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