title: Time-dependent effects of cadaveric renal transplantation on arterial compliance in patients with end-stage renal disease.
abstract: BACKGROUND
  Cardiovascular complications are the leading cause of mortality in patients undergoing hemodialysis. Increased arterial stiffness is a strong and independent predictor of cardiovascular risk in these patients. In the present study, we investigated the time-dependent effects of cadaveric renal transplantation on arterial elasticity in end-stage renal disease patients.
  
  
  METHODS
  Thirty-six patients underwent successful cadaveric kidney transplantation. Pulse-wave analysis of the radial artery was performed prior to transplantation (day 0) and at six defined intervals after transplantation (day 1 to 90). Compliance of large conduit arteries (C1) and of small resistance arteries (C2) was assessed using a modified Windkessel model of the circulation.
  
  
  RESULTS
  Both large artery and small artery compliance were transiently improved within the first four weeks posttransplant reaching a maximum of 122 +/- 42% (C1) and 147 +/- 93% (C2) between day 19 and 23. After the first month, however, elasticity gradually deteriorated to reach baseline values three months after transplantation again.
  
  
  CONCLUSIONS
  The benefits of cadaveric renal transplantation on oscillatory and capacitive artery compliance are only transient. It may be speculated that the subacute and long-term vasoactive effects of calcineurin inhibitors counteract the metabolic benefits of increased renal function on the vasculature.
authors.affiliation: Medizinische Klinik IV, Nephrology, Charité--Campus Benjamin Franklin, Berlin, Germany. timm.westhoff@charite.de
authors.forename: Timm H
authors.initials: TH
authors.lastname: Westhoff
authors.forename: Henriette
authors.initials: H
authors.lastname: Straub-Hohenbleicher
authors.forename: Matthias
authors.initials: M
authors.lastname: Basdorf
authors.forename: Simone
authors.initials: S
authors.lastname: van der Giet
authors.forename: Sven
authors.initials: S
authors.lastname: Schmidt
authors.forename: Gerd
authors.initials: G
authors.lastname: Offermann
authors.forename: Peter
authors.initials: P
authors.lastname: Schlattmann
authors.forename: Walter
authors.initials: W
authors.lastname: Zidek
authors.forename: Markus
authors.initials: M
authors.lastname: van der Giet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries / Q000187:drug effects / Q000503:physiopathology*; D002102:Cadaver; D003187:Compliance; D016572:Cyclosporine / Q000494:pharmacology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine