title: Longitudinal analysis of vascular function and biomarkers of metabolic bone disorders before and after renal transplantation.
abstract: OBJECTIVE
  The role of chronic kidney disease-mineral bone disorder (CKD-MBD) reversibility in the amelioration of vascular function and in the reduction of the risk for cardiovascular events after renal transplantation is still unknown.
  
  
  METHODS
  We investigated the longitudinal relationship between the main biomarkers of CKD-MBD and the evolution of vascular function [flow-mediated dilatation (FMD)] after transplantation in a series of 161 patients with kidney failure maintained on chronic dialysis (5D-CKD).
  
  
  RESULTS
  Before transplantation, FMD in patients was markedly lower (-40%, p < 0.001) than in well-matched healthy subjects and increased by 27% after transplantation (p = 0.001). Fibroblast growth factor 23 (FGF23), 25-hydroxy-vitamin D (25OHVD) and serum phosphate (p < 0.01) were independently associated with simultaneous changes in FMD. Changes in classical risk factors and in risk factors related to CKD like the glomerular filtration rate, serum albumin, C-reactive protein and insulin resistance failed to independently explain the variability in FMD changes after transplantation.
  
  
  CONCLUSIONS
  Endothelium-dependent vasodilatation improves after kidney transplantation, which is parallel to the dramatic fall in FGF23, the reduction in serum phosphorus and the increase in 25OHVD levels. If these associations are causal, a part of decline in cardiovascular risk after transplantation is related to partial resolution of CKD-MBD.
authors: Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey. mahmutiyilmaz@yahoo.com
authors: Mahmut Ilker
authors: MI
authors: Yilmaz
authors: Alper
authors: A
authors: Sonmez
authors: Mutlu
authors: M
authors: Saglam
authors: Halil
authors: H
authors: Yaman
authors: Selim
authors: S
authors: Kilic
authors: Turker
authors: T
authors: Turker
authors: Hilmi Umut
authors: HU
authors: Unal
authors: Mahmut
authors: M
authors: Gok
authors: Hakki
authors: H
authors: Cetinkaya
authors: Tayfun
authors: T
authors: Eyileten
authors: Yusuf
authors: Y
authors: Oguz
authors: Kayser
authors: K
authors: Caglar
authors: Abdulgaffar
authors: A
authors: Vural
authors: Francesca
authors: F
authors: Mallamaci
authors: Carmine
authors: C
authors: Zoccali
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001808:Blood Vessels / Q000503:physiopathology*; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000209:etiology; D004108:Dilatation, Pathologic / Q000209:etiology / Q000503:physiopathology; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D016030:Kidney Transplantation; D008137:Longitudinal Studies; D008297:Male; D010710:Phosphates / Q000097:blood*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000601:surgery; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D010710:Phosphates; D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; C104450:25-hydroxyvitamin D