Endothelial dysfunction and fetuin A levels before and after kidney transplantation.
BACKGROUND
Endothelial dysfunction (ED) has a major role in the cardiovascular outcome of patients with chronic kidney disease (CKD). The aim of this study was to investigate the relation between fetuin A levels and ED in kidney transplant recipients.


METHODS
Forty-two living donor kidney transplant recipients, 21 (11 male) on cyclosporine A and 21 (10 male) on tacrolimus-based regimes, were studied. Forty-two (21 male) healthy subjects were enrolled as controls. Fetuin A, highly sensitive C-reactive protein (hsCRP) levels, brachial artery endothelium-dependent vasodilatation (FMD), nitroglycerine mediated dilatation (NMD), and carotid intima-media thickness (CIMT) were measured before transplantation and on the 30th and 90th days posttransplant.


RESULTS
Pretransplantation serum fetuin A concentrations and FMD values of patients were significantly lower than those of the controls (P<0.001 for both). These were significantly increased in the 30th and 90th days posttransplantation There was a significant positive correlation between Fetuin A and FMD levels both before and after kidney transplantation (r=0.534, r=0.576; respectively, P<0.001 for both). Carotid intima-media thickness and hsCRP levels decreased after transplantation (P<0.001 for all). According to the regression analysis, fetuin A, intact parathyroid hormone, and hsCRP levels were the independent determinants of FMD.


CONCLUSIONS
The results of the present study suggest that low serum fetuin A levels in CKD may contribute to impaired endothelial functions in CKD. Future studies should clarify the role of fetuin A levels in cardiovascular outcomes of CKD.
Caglar
Kayser
K
Department of Nephrology, Gülhane School of Medicine, Ankara, Turkey. kaysercaglar@yahoo.com
Yilmaz
Mahmut Ilker
MI
Saglam
Mutlu
M
Cakir
Erdinc
E
Kilic
Selim
S
Eyileten
Tayfun
T
Sonmez
Alper
A
Oguz
Yusuf
Y
Oner
Koksal
K
Ors
Fatih
F
Vural
Abdulgaffar
A
Yenicesu
Mujdat
M
D000328:Adult; D001798:Blood Proteins / Q000378:metabolism*; D004727:Endothelium / Q000503:physiopathology; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000378:metabolism* / Q000503:physiopathology* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D014664:Vasodilation; D060749:alpha-2-HS-Glycoprotein
C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein