Pulse wave velocity in children following renal transplantation.
BACKGROUND
Arterial stiffness (ASt) increases with age, a process accelerated by uraemia and reversed by transplantation (Tx). Increased ASt results in an elevated pulse wave velocity (PWV).


METHODS
To compare the PWV of Tx patients (n = 25, age = 15.1/95% CI = 13.5-16.7/year) and healthy controls, three control groups were formed: matched for age (A), for height and weight (H/W) and for age and height (A/H), respectively. To avoid bias from the growth deficit of Tx, firstly Z-scores of PWV were calculated (PWV-Z). Second, the PWV/height (PWV/h) ratio was assessed. Pre-Tx serum Ca, P, PTH and the cumulative dose of calcitriol (cCTL) were also analysed. Finally, Tx patients were compared to ESRD patients (n = 11). PWV was measured by applanation tonometry.


RESULTS
Tx were smaller than A and older than H/W. The PWV of Tx differed only from H/W and A/H. PWV-Z and PWV/h of Tx were increased compared to all control groups. They correlated with the CaxP and cCTL before Tx and were independent of age. Patients with creatinine clearance >90 ml/min/1.73 m(2) or <1 year on dialysis had lower PWV-Z and PWV/h than ESRD.


CONCLUSIONS
Controls that matched for both age and height should be used to assess PWV in children with growth failure. PWV-Z is a universal age-independent parameter of PWV in cases of growth retardation; PWV/h is a simple alternative of PWV-Z. CaxP and cCTL are major determinants of ASt after Tx. PWV may be reduced after Tx suggesting that the uraemia-induced cardiovascular changes might be reversible.
Cseprekál
Orsolya
O
Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Kis
Eva
E
Schäffer
Péter
P
Othmane
Taha El Hadj
Tel H
Fekete
Bertalan Cs
BC
Vannay
Adám
A
Szabó
Attila J
AJ
Remport
Adám
A
Szabó
András
A
Tulassay
Tivadar
T
Reusz
György S
GS
D000293:Adolescent; D001783:Blood Flow Velocity; D001827:Body Height; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D014655:Vascular Resistance; D055815:Young Adult