Pediatric Nephrology

, Volume 23, Issue 12, pp 2241–2245 | Cite as

Arterial stiffness in children after renal transplantation

  • Sonia Briese
  • Maren Claus
  • Uwe QuerfeldEmail author
Original Article


Long-term survival after successful transplantation is limited by cardiovascular disease. We studied changes in arterial function in children after renal transplantation. We measured pulse-wave velocity (PWV) and the augmentation index (AIX) as estimated from central pulse-wave analysis in 36 patients with a functioning kidney transplant (mean age 14 ± 3.4 years) and 49 healthy children (mean age 13.3 ± 3.3 years). Transplantation had been performed 4.3 ± 3.3 years prior to examination. Transplanted patients had a significantly higher mean PWV of 5.43 ± 0.9 m/s; controls 4.68 ± 0.7 m/s. Likewise, the AIX was significantly higher in patients (–14.3 ± 15.2) than in controls –26.3 ± 13.5. We found no significant associations with the degree of transplant dysfunction, glomerular filtration rate (GFR) loss, or dose of immunosuppressive medications; however, the AIX was associated with the serum calcium-phosphorus product, and PWV correlated with systolic blood pressure and age. This study suggests that subclinical arteriopathy is present in young transplant recipients.


Renal transplantation Children Arterial stiffness Cardiovascular disease Pulse-wave analysis 


  1. 1.
    Moreso F, Grinyo JM (2007) Graft dysfunction and cardiovascular risk–an un-holy alliance. Nephrol Dial Transplant 22:699–702PubMedCrossRefGoogle Scholar
  2. 2.
    Benedetto FA, Mallamaci F, Tripepi G, Zoccali C (2001) Prognostic value of ultrasonographic measurement of carotid intima media thickness in dialysis patients. J Am Soc Nephrol 12:2458–2464PubMedGoogle Scholar
  3. 3.
    Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H (2006) Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 27:2588–2605PubMedCrossRefGoogle Scholar
  4. 4.
    Groothoff JW, Gruppen MP, Offringa M, de Groot E, Stok W, Bos WJ, Davin JC, Lilien MR, van de Kar NC, Wolff ED, Heymans HS (2002) Increased arterial stiffness in young adults with end-stage renal disease since childhood. J Am Soc Nephrol 13:2953–2961PubMedCrossRefGoogle Scholar
  5. 5.
    Briese S, Wiesner S, Will JC, Lembcke A, Opgen-Rhein B, Nissel R, Wernecke KD, Andreae J, Haffner D, Querfeld U (2006) Arterial and cardiac disease in young adults with childhood-onset end-stage renal disease-impact of calcium and vitamin D therapy. Nephrol Dial Transplant 21:1906–1914PubMedCrossRefGoogle Scholar
  6. 6.
    Oh J, Wunsch R, Turzer M, Bahner M, Raggi P, Querfeld U, Mehls O, Schaefer F (2002) Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation 106:100–105PubMedCrossRefGoogle Scholar
  7. 7.
    Litwin M, Wuhl E, Jourdan C, Trelewicz J, Niemirska A, Fahr K, Jobs K, Grenda R, Wawer ZT, Rajszys P, Troger J, Mehls O, Schaefer F (2005) Altered morphologic properties of large arteries in children with chronic renal failure and after renal transplantation. J Am Soc Nephrol 16:1494–1500PubMedCrossRefGoogle Scholar
  8. 8.
    Shroff RC, Donald AE, Hiorns MP, Watson A, Feather S, Milford D, Ellins EA, Storry C, Ridout D, Deanfield J, Rees L (2007) Mineral metabolism and vascular damage in children on dialysis. J Am Soc Nephrol 18:2996–3003PubMedCrossRefGoogle Scholar
  9. 9.
    Civilibal M, Caliskan S, Adaletli I, Oflaz H, Sever L, Candan C, Canpolat N, Kasapcopur O, Kuruoglu S, Arisoy N (2006) Coronary artery calcifications in children with end-stage renal disease. Pediatr Nephrol 21:1426–1433PubMedCrossRefGoogle Scholar
  10. 10.
    Schwenger V, Keller T, Hofmann N, Hoffmann O, Sommerer C, Nahm AM, Morath C, Zeier M, Krumme B (2006) Color Doppler indices of renal allografts depend on vascular stiffness of the transplant recipients. Am J Transplant 6:2721–2724PubMedCrossRefGoogle Scholar
  11. 11.
    Zoungas S, Kerr PG, Chadban S, Muske C, Ristevski S, Atkins RC, McNeil JJ, McGrath BP (2004) Arterial function after successful renal transplantation. Kidney Int 65:1882–1889PubMedCrossRefGoogle Scholar
  12. 12.
    O’leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr (1999) Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 340:14–22PubMedCrossRefGoogle Scholar
  13. 13.
    London GM, Blacher J, Pannier B, Guerin AP, Marchais SJ, Safar ME (2001) Arterial wave reflections and survival in end-stage renal failure. Hypertension 38:434–438PubMedGoogle Scholar
  14. 14.
    Bahous SA, Stephan A, Barakat W, Blacher J, Asmar R, Safar ME (2004) Aortic pulse wave velocity in renal transplant patients. Kidney Int 66:1486–1492PubMedCrossRefGoogle Scholar
  15. 15.
    Covic A, Goldsmith DJ, Gusbeth-Tatomir P, Buhaescu I, Covic M (2003) Successful renal transplantation decreases aortic stiffness and increases vascular reactivity in dialysis patients. Transplantation 76:1573–1577PubMedCrossRefGoogle Scholar
  16. 16.
    Strozecki P, Adamowicz A, Wlodarczyk Z, Manitius J (2007) The influence of calcineurin inhibitors on pulse wave velocity in renal transplant recipients. Ren Fail 29:679–684PubMedCrossRefGoogle Scholar
  17. 17.
    Wystrychowski G, Chudek J, Zukowska-Szczechowska E, Wiecek A, Grzeszczak W (2008) Associations between calcineurin inhibitors and arterial compliance in kidney transplant recipients. J Nephrol 21:81–92PubMedCrossRefGoogle Scholar
  18. 18.
    Cohen DL, Warburton KM, Warren G, Bloom RD, Townsend RR (2004) Pulse wave analysis to assess vascular compliance changes in stable renal transplant recipients. Am J Hypertens 17:209–212PubMedCrossRefGoogle Scholar
  19. 19.
    Martinez-Castelao A, Sarrias X, Bestard O, Gil-Vernet S, Seron D, Cruzado JM, Moreso F, Diez-Noguera A, Grinyo JM (2005) Arterial elasticity measurement in renal transplant patients under anticalcineurin immunosuppression. Transplant Proc 37:3788–3790PubMedCrossRefGoogle Scholar
  20. 20.
    Calo LA, Davis PA, Giacon B, Pagnin E, Sartori M, Riegler P, Antonello A, Huber W, Semplicini A (2002) Oxidative stress in kidney transplant patients with calcineurin inhibitor-induced hypertension: effect of ramipril. J Cardiovasc Pharmacol 40:625–631PubMedCrossRefGoogle Scholar
  21. 21.
    Augustine JJ, Bodziak KA, Hricik DE (2007) Use of sirolimus in solid organ transplantation. Drugs 67:369–391PubMedCrossRefGoogle Scholar

Copyright information

© IPNA 2008

Authors and Affiliations

  1. 1.Department of Pediatric NephrologyCharité Universitätsmedizin BerlinBerlinGermany
  2. 2.Department of Pediatric NephrologyCharité University HospitalBerlinGermany

Personalised recommendations