title: Arterial stiffness and wave reflections in renal transplant recipients.
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 (51)Cr-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.
authors.affiliation: University Hospital Ghent, Department of Internal Medicine, Nephrology section, De Pintelaan 185 B-9000 Gent, Belgium. francis.verbeke@UGent.be
authors.forename: Francis
authors.initials: F
authors.lastname: Verbeke
authors.forename: Wim
authors.initials: W
authors.lastname: Van Biesen
authors.forename: Patrick
authors.initials: P
authors.lastname: Peeters
authors.forename: Luc M
authors.initials: LM
authors.lastname: Van Bortel
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Vanholder
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000473:pathology*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000473:pathology*; D002339:Carotid Arteries / Q000473:pathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007249:Inflammation; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012306:Risk; D016896:Treatment Outcome