Factors associated with increased arterial stiffness in renal transplant recipients.
BACKGROUND
Pulse wave velocity (PWV) is a marker of arterial stiffness. It was shown that PWV is related to increased cardiovascular risk in renal transplant recipients (RTR). Renal transplantation leads to decrease of arterial stiffness when compared with dialysis patients. Despite many studies, causes of increased arterial stiffness in RTR are not well defined. This study sought to investigate the association between cardiovascular risk factors, graft function, cardiovascular and immunosuppressive therapy, and carotid-femoral PWV in renal transplant recipients.


METHODS
Carotid-femoral PWV were measured with Complior device in 207 (73 female and 134 male) RTR aged 45+/-12 years, and in 21 healthy volunteers as controls.


RESULTS
Pulse wave velocity was higher in RTR compared with controls: 9.2+/-2.1 m/s vs 8.3+/-1.5m/s (P<.05). In RTR group, significant correlations were found between PWV and age (r=0,55; P<.001), male sex (r=0.17; P<.02), body weight (r=0.23; P<.01), systolic (SBP) (r=0.36; P<.001), and diastolic blood pressure (DBP) (r=0.19; P<.01), pulse pressure (pulse pressure) (r=0.34; P<.001), mean arterial pressure (MAP) (r=0.28; P<.001), number of antihypertensive medication (r=0.17; P<.02), fasting glucose (r=0.24; P<.01), presence of diabetes (r=0.24; P<.01), eGFR (r=-0.19; P<.01), therapy with cyclosporine (r=0.29; P<.001), and therapy with tacrolimus (r=-0.22; P<.01). In stepwise multiple regression analysis, age, male sex, MAP, cyclosporine, and fasting glucose concentration were independently associated with increased PWV.


CONCLUSIONS
Arterial stiffness is increased in RTR. Type of immunosuppressive regimen, high blood pressure, and glucose metabolism disturbances should be considered as potential targets to reduce increased arterial stiffness in RTR.
Strózecki
Paweł
P
Depertment of Nephrology, Hypertension and Internal Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland. st_pawel@cm.umk.pl
Adamowicz
Andrzej
A
Włodarczyk
Zbigniew
Z
Manitius
Jacek
J
D000328:Adult; D000368:Aged; D001158:Arteries / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis
D007166:Immunosuppressive Agents; D016572:Cyclosporine