The influence of calcineurin inhibitors on pulse wave velocity in renal transplant recipients.
BACKGROUND
Pulse wave velocity (PWV) is a marker of the arterial wall stiffness and independent cardiovascular risk factor in hemodialysis patients. Cyclosporine A (CyA) and tacrolimus (TAC) are known to differ in the influence on cardiovascular risk factors in renal transplant recipients. Recent studies suggest that CyA may decrease arterial compliance. The aim of the study was to assess the influence of CyA and TAC on the PWV and arterial wall stiffness in renal transplant recipients.


METHODS
The study population consisted of two groups of cadaveric renal transplant recipients, 76 patients each, matched for age, sex, blood pressure, body mass index, and length of the post-transplant follow-up. PWV between carotid and femoral artery was measured using a Complior device. Fasting blood was sampled for serum creatinine, lipid profile, uric acid, glucose, and C-reactive protein.


RESULTS
Aortic pulse wave velocity -- a marker of increased arterial stiffness -- was significantly higher in CyA group compared with TAC group (9.33 +/- 2.10 vs. 8.54 +/- 1.35, respectively; p < 0.01). Uric acid, total cholesterol, triglycerides, and LDL-cholesterol concentrations were significantly higher in CyA group. Significant correlations were found between PWV and age, systolic and diastolic blood pressure, and fasting glucose in the CyA group, but only between PWV and age in TAC group.


CONCLUSIONS
CyA-based immunosuppressive therapy is associated with an unfavorable profile of cardiovascular risk factors and increased arterial stiffness in renal transplant recipients.
Strózecki
Paweł
P
Department of Nephrology, Hypertension and Internal Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University Torun, Poland. st_pawel@cm.umk.pl
Adamowicz
Andrzej
A
Włodarczyk
Zbigniew
Z
Manitius
Jacek
J
D001011:Aorta / Q000503:physiopathology; D065095:Calcineurin Inhibitors; D003187:Compliance; D016572:Cyclosporine / Q000494:pharmacology*; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D016030:Kidney Transplantation; D008297:Male; D011673:Pulsatile Flow / Q000187:drug effects*; D011674:Pulse; D016559:Tacrolimus / Q000494:pharmacology*
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus