title: Renal function decline in recipients and donors of kidney grafts: role of aortic stiffness.
abstract: OBJECTIVE
  Renal function decreases over time as a result of reduction in the number of functioning nephrons with age. In recipients and donors of kidney grafts, renal function decline may be linked differently to various parameters, namely arterial stiffness.
  
  
  METHODS
  We conducted a prospective cohort study including 101 recipients of kidney grafts and their donors aiming at determining the factors correlated to the renal function decline over time. Aortic stiffness was evaluated by the non-invasive measurement of aortic pulse wave velocity. The glomerular filtration rate was estimated using the Modification of Diet in Renal Disease (MDRD) equation and the annualized change was determined.
  
  
  RESULTS
  Decline in renal function was estimated at 1-year post-transplantation and annually thereafter (median follow-up 8 years, range 3.6-18.3), as the mean of the annualized decrease in the glomerular filtration rate. In recipients, filtration rate decreased by 4.8 ± 19.7 ml/min/1.73 m(2) the first post-transplant year and at a yearly rate of 2.2 ± 3.8 ml/min/1.73 m(2) thereafter. The first-year decline was related to smoking and acute rejection. Later decline was significantly associated with donor age and aortic stiffness. In living donors, renal function decline after the first year corresponded to 0.7 ml/min/1.73 m(2), was significantly lower than that of recipients (p < 0.001), and was determined by donor age at nephrectomy.
  
  
  CONCLUSIONS
  Recipients of kidney grafts show a glomerular filtration rate decline over time that is significantly associated with donor age and aortic stiffness after the first post-transplant year, while donors demonstrate a lower decline that is mostly determined by age at nephrectomy.
authors: Division of Nephrology and Renal Transplantation, University Medical Center-Rizk Hospital, Ashrafieh, Beirut, Lebanon.
authors: Sola Aoun
authors: SA
authors: Bahous
authors: Maya
authors: M
authors: Khairallah
authors: Jad
authors: J
authors: Al Danaf
authors: Rim
authors: R
authors: Halaby
authors: Serge
authors: S
authors: Korjian
authors: Yazan
authors: Y
authors: Daaboul
authors: Pascale
authors: P
authors: Salameh
authors: Antoine
authors: A
authors: Stephan
authors: Jacques
authors: J
authors: Blacher
authors: Michel E
authors: ME
authors: Safar
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012907:Smoking / Q000503:physiopathology; D014019:Tissue Donors; D019737:Transplants / Q000503:physiopathology*; D059289:Vascular Stiffness / Q000502:physiology*; D055815:Young Adult