title: Arterial stiffness in kidney transplantation: a single center case-control study comparing belatacept versus calcineurin inhibitor immunosuppressive based regimen.
abstract: Arterial stiffness is nowadays a well-accepted predictor of cardiovascular mortality in general population; as well as in kidney transplant recipient population. The femoral-carotid pulse wave velocity (cf-PWV) is the widest used method to assess the arterial stiffness. The aim of this study was to test whether CNI-free immunosuppression based on belatacept was associated with lower cf-PWV, as a surrogate marker of arterial stiffness, than CNI. This was a retrospective case-control study. We included all the cases treated with belatacept as a maintenance immunosuppression in our center (n=20). An appropriate control group of patients (n=20) treated with CNI was selected to achieve match for key factors associated with arterial stiffness. After a follow-up of 5 years after transplantation, the Belatacept group had a reduced prevalence of patients with a cf-PWV higher than 8.1m/s (50% in BLC vs. 25% in CNI, p=0.08). At multivariate logistic regression analysis, the risk of high cf-PWV was correlated with age (OR 1.24; p&lt;0.03) and renal resistive index (OR 1.25; p&lt;0.05). Belatacept treatment was associated with a significant reduction in risk of cf-PWV (OR 0.008; P=0.045). Belatacept-based maintenance immunosuppression could improve kidney transplant recipient&rsquo;s survival by reducing cardiovascular events related to stiffness.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Melilli
authors.forename: Oriol
authors.initials: O
authors.lastname: Bestard-Matamoros
authors.forename: Anna
authors.initials: A
authors.lastname: Manonelles-Montero
authors.forename: Neus
authors.initials: N
authors.lastname: Sala-Bassa
authors.forename: Richard
authors.initials: R
authors.lastname: Mast
authors.forename: Josep M
authors.initials: JM
authors.lastname: Grinyó-Boira
authors.forename: Josep M
authors.initials: JM
authors.lastname: Cruzado
mesh_terms: D000069594:Abatacept / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001011:Aorta / Q000187:drug effects; D065095:Calcineurin Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012307:Risk Factors; D059289:Vascular Stiffness / Q000187:drug effects*
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D000069594:Abatacept