title: Reduction in augmentation index after successful renal transplantation.
abstract: BACKGROUND
  Patients of end stage renal disease (ESRD) have an increased risk of cardiovascular events. Arterial stiffness is an established independent predictor of cardiovascular morbidity and mortality in ESRD patients. Carotid femoral pulse wave velocity (c-f PWV) and augmentation index (AI) are the indices which are used for the noninvasive assessment of arterial stiffness. Renal transplantation (RT) as a treatment modality in ESRD patients is associated with improvement in cardiovascular survival. Whether this improvement is due to attenuation of arterial stiffness has been inadequately investigated. The present study was conducted in ESRD patients before and 3 months after RT to assess the reversibility of the abnormalities of vascular compliance that are known to be associated with adverse outcome.
  
  
  METHODS
  Arterial stiffness indices (c-f PWV and AI) were measured using the principle of applanation tonometry with a SphygmoCor CvMS system (Atcor Medicals, Australia) in 23 ESRD patients (age: 35.9 ± 9.3 years) before and 3 months after successful RT.
  
  
  RESULTS
  After transplantation, augmentation index values reduced significantly as compared to their pre-transplant values (27.7 ± 11.3 % vs. 17.1 ± 9.0 %; P < 0.0001), while the carotid femoral pulse wave velocity values did not differ significantly (8.7 ± 2.0 vs. 8.6 ± 3.2 m/s). The augmentation index was correlated with the biochemical parameters of serum creatinine (Pearson r = 0.3628; P = 0.0128) and calcium phosphate product (Pearson r = 0.3868; P = 0.0079).
  
  
  CONCLUSIONS
  Restoration of renal function following successful RT is associated with differential effects on the two indices of arterial stiffness. The salient finding of our study is that 3 months after transplantation, functional changes in vasculature lead to a significant reduction in the augmentation index, while the pulse wave velocity may take longer to show an improvement.
authors: Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
authors: Manpreet
authors: M
authors: Kaur
authors: Charanjit
authors: C
authors: Lal
authors: Dipankar
authors: D
authors: Bhowmik
authors: Ashok Kumar
authors: AK
authors: Jaryal
authors: Kishore Kumar
authors: KK
authors: Deepak
authors: Sanjay Kumar
authors: SK
authors: Agarwal
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation; D008137:Longitudinal Studies; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010710:Phosphates / Q000097:blood; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; D010710:Phosphates; D003404:Creatinine; D002118:Calcium