title: Clinical Significance of Pre-Transplant Arterial Stiffness and the Impact of Kidney Transplantation on Arterial Stiffness.
abstract: BACKGROUND
  Arterial stiffness is closely associated with cardiovascular disease (CVD) in end stage renal disease (ESRD) patients. However, the clinical significance of pre-transplant arterial stiffness and the impact of kidney transplantation (KT) on arterial stiffness have not yet been determined.
  
  
  METHODS
  We measured the brachial-ankle pulse wave velocity (baPWV) before KT and one year after KT. We evaluated the potential utility of pre-transplant baPWV as a screening test to predict CVD. The impact of KT on progression of arterial stiffness was evaluated according to changes in baPWV after KT. The factors that influence the change of baPWV after KT were also examined.
  
  
  RESULTS
  The mean value of pre-transplant baPWV was 1508 ± 300 cm/s in ESRD patients; 93.4% had a higher baPWV value than healthy controls. Pre-transplant baPWV was higher in patients with CVD than in those without CVD (1800 ± 440 vs. 1491 ± 265 cm/s, p<0.05), and was a strong predictive factor of CVD (OR 1.003, p<0.05). The optimal cut-off value of baPWV for the detection of CVD was 1591 cm/s, and this value was an independent predictor of CVD in KT recipients (OR 6.3, p<0.05). The post-transplant baPWV was significantly decreased compared to that of pre-transplant rates (1418 ± 235 vs. 1517 ± 293 cm/s, p<0.05), and progression of arterial stiffness was not observed in 86.9% patients. Logistic regression analysis revealed that higher body mass index and the degree of increase in calcium levels were independent risk factors that affected baPWV after KT.
  
  
  CONCLUSIONS
  Evaluation of arterial stiffness with baPWV is a useful screening test for predicting CVD after KT, and KT is effective in preventing the progression of arterial stiffness in ESRD patients.
authors.affiliation: Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hyun Seon
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jaeho
authors.initials: J
authors.lastname: Seung
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
authors.affiliation: Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology*; D002118:Calcium / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D016022:Case-Control Studies; D003710:Demography; D018450:Disease Progression; D005260:Female; D006439:Hemodynamics; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000503:physiopathology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012372:ROC Curve; D012016:Reference Values; D012307:Risk Factors; D059289:Vascular Stiffness
chemical_list: D002118:Calcium