Advertisement

Kidney transplantation improves arterial stiffness in patients with end-stage renal disease

  • Sujuan Feng
  • Haozhou Wang
  • Jing Yang
  • Xiaopeng Hu
  • Wei Wang
  • Hang Liu
  • Han LiEmail author
  • Xiaodong ZhangEmail author
Urology - Original Paper

Abstract

Background

Cardiovascular disease (CVD) is the leading cause of mortality among the patients with end-stage renal disease (ESRD). Arterial stiffness is a well-accepted predictor of cardiovascular mortality in general population and ESRD patients. The aim of this study was to compare the change of arterial stiffness in kidney transplant recipients (KTRs) and ESRD patients, and further investigate the impact of kidney transplantation (KT) on arterial stiffness.

Methods

A total of 138 maintenance hemodialysis patients, 198 KTRs and 75 healthy volunteers were enrolled in this study. The carotid-femoral pulse wave velocity (CF-PWV) and carotid-radial PWV (CR-PWV) were determined, and the correlations of PWV with biochemical parameters were analyzed.

Results

CF-PWV was highest in the maintenance hemodialysis patients, but similar between KTRs and healthy volunteers. Bivariate correlation analysis among KTRs demonstrated that CF-PWV was positively correlated with high level of peripheral diastolic blood pressure, pulse pressure, mean artery pressure, BUN and HDL, but negatively correlated with albumin. Univariate polytomous logistic regression analysis showed that age, BMI, systolic blood pressure, pulse pressure, length of KT and BUN were associated with the increase of CF-PWV value.

Conclusions

Aortic stiffness could be improved after KT. Meanwhile, age, BMI, systolic blood pressure, pulse pressure, length of KT and BUN were independent predictors of the increase of CF-PWV in KTRs.

Keywords

Aortic stiffness Cardiovascular disease Kidney transplantation Pulse wave velocity 

Abbreviations

CVD

Cardiovascular diseases

ESRD

End-stage renal disease

KT

Kidney transplantation

CF-PWV

Carotid-femoral pulse wave velocity

CR-PWV

Carotid-radial pulse wave velocity

Notes

Funding

This work was supported by Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201408).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Consent to participate

There is no organ were obtained from prisoners and the kidney always were obtained from emergency department and neurology department of Beijing Chao-Yang Hospital, Capital Medical University.

References

  1. 1.
    Stoumpos S, Jardine AG, Mark PB (2015) Cardiovascular morbidity and mortality after kidney transplantation. Transplant Int 28(1):10–21CrossRefGoogle Scholar
  2. 2.
    Jardine AG, Gaston RS, Fellstrom BC, Holdaas H (2011) Prevention of cardiovascular disease in adult recipients of kidney transplants. Lancet 378(9800):1419–1427CrossRefGoogle Scholar
  3. 3.
    Meier-Kriesche HU, Schold JD, Srinivas TR, Reed A, Kaplan B (2004) Kidney transplantation halts cardiovascular disease progression in patients with end-stage renal disease. Am J Transplant 4(10):1662–1668CrossRefGoogle Scholar
  4. 4.
    Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank JK, De Backer T, Filipovsky J, Huybrechts S, Mattace-Raso FU, Protogerou AD et al (2012) Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens 30(3):445–448CrossRefGoogle Scholar
  5. 5.
    Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, Boutouyrie P, Cameron J, Chen CH, Cruickshank JK et al (2014) Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol 63(7):636–646CrossRefGoogle Scholar
  6. 6.
    Verbeke F, Marechal C, Van Laecke S, Van Biesen W, Devuyst O, Van Bortel LM, Jadoul M, Vanholder R (2011) Aortic stiffness and central wave reflections predict outcome in renal transplant recipients. Hypertension 58(5):833–838CrossRefGoogle Scholar
  7. 7.
    Ignace S, Utescu MS, De Serres SA, Marquis K, Gaudreault-Tremblay MM, Lariviere R, Cote I, Houde I, Lebel M, Agharazii M (2011) Age-related and blood pressure-independent reduction in aortic stiffness after kidney transplantation. J Hypertens 29(1):130–136CrossRefGoogle Scholar
  8. 8.
    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(11):1573–1577CrossRefGoogle Scholar
  9. 9.
    Ro H, Kim AJ, Chang JH, Jung JY, Chung WK, Park YH, Lee HH (2016) Can kidney transplantation improve arterial stiffness in end-stage renal patients? Transpl Proc 48(3):884–886CrossRefGoogle Scholar
  10. 10.
    Birdwell KA, Jaffe G, Bian A, Wu P, Ikizler TA (2015) Assessment of arterial stiffness using pulse wave velocity in tacrolimus users the first year post kidney transplantation: a prospective cohort study. BMC Nephrol 16:93CrossRefGoogle Scholar
  11. 11.
    Reference Values for Arterial Stiffness Collabration (2010) Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: 'establishing normal and reference values'. Eur Heart J 31(19):2338–2350CrossRefGoogle Scholar
  12. 12.
    Bahous SA, Stephan A, Barakat W, Blacher J, Asmar R, Safar ME (2004) Aortic pulse wave velocity in renal transplant patients. Kidney Int 66(4):1486–1492CrossRefGoogle Scholar
  13. 13.
    Meier-Kriesche HU, Ojo AO, Port FK, Arndorfer JA, Cibrik DM, Kaplan B (2001) Survival improvement among patients with end-stage renal disease: trends over time for transplant recipients and wait-listed patients. J Am Soc Nephrol JASN 12(6):1293–1296PubMedGoogle Scholar
  14. 14.
    Rao NN, Coates PT (2018) Cardiovascular disease after kidney transplant. Semin Nephrol 38(3):291–297CrossRefGoogle Scholar
  15. 15.
    Kim HS, Seung J, Lee JH, Chung BH, Yang CW (2015) Clinical significance of pre-transplant arterial stiffness and the impact of kidney transplantation on arterial stiffness. PLoS ONE 10(9):e0139138CrossRefGoogle Scholar
  16. 16.
    Neale J, Smith AC (2015) Cardiovascular risk factors following renal transplant. World J Transplant 5(4):183–195CrossRefGoogle Scholar
  17. 17.
    Seibert FS, Behrendt C, Pagonas N, Bauer F, Kiziler F, Zidek W, Westhoff TH (2015) Prediction of cardiovascular events after renal transplantation. Transpl Proc 47(2):388–393CrossRefGoogle Scholar
  18. 18.
    Czyzewski L, Wyzgal J, Czyzewska E, Kurowski A, Sierdzinski J, Truszewski Z, Szarpak L (2016) Assessment of arterial stiffness, volume, and nutritional status in stable renal transplant recipients. Medicine 95(6):e2819CrossRefGoogle Scholar
  19. 19.
    Kovacs D, Szabo L, Fedor R, Laczik R, Soltesz P, Locsey L, Asztalos L (2011) Prospective study of changes in arterial stiffness among kidney-transplanted patients. Transpl Proc 43(4):1252–1253CrossRefGoogle Scholar
  20. 20.
    Kasiske BL, Anjum S, Shah R, Skogen J, Kandaswamy C, Danielson B, O'Shaughnessy EA, Dahl DC, Silkensen JR, Sahadevan M et al (2004) Hypertension after kidney transplantation. Am J Kidney Dis 43(6):1071–1081CrossRefGoogle Scholar
  21. 21.
    Mange KC, Cizman B, Joffe M, Feldman HI (2000) Arterial hypertension and renal allograft survival. JAMA 283(5):633–638CrossRefGoogle Scholar
  22. 22.
    Locsey L, Szlanka B, Borbas B, Szabo L, Dan A, Asztalos L, Fedor R, Menes I, Lorincz I (2010) Arterial stiffness in chronic renal failure and after renal transplantation. Transpl Proc 42(6):2299–2303CrossRefGoogle Scholar
  23. 23.
    Mitchell A, Opazo Saez A, Kos M, Witzke O, Kribben A, Nurnberger J (2010) Pulse wave velocity predicts mortality in renal transplant patients. Eur J Med Res 15(10):452–455CrossRefGoogle Scholar
  24. 24.
    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(11):2721–2724CrossRefGoogle Scholar
  25. 25.
    Hsu BG, Liou HH, Lee CJ, Chen YC, Ho GJ, Lee MC (2016) Serum sclerostin as an independent marker of peripheral arterial stiffness in renal transplantation recipients: a cross-sectional study. Medicine 95(15):e3300CrossRefGoogle Scholar
  26. 26.
    Monfared A, Azimi SZ, Kazemnezhad E, Khosravi M, Lebadi M, Mirzajani E, Ashtiani MN (2014) Hyperhomocysteinemia and assessment of its associated factors in renal transplant recipients: a single-center study in northern Iran. Transplantation 98(1):66–71PubMedGoogle Scholar

Copyright information

© Springer Nature B.V. 2020

Authors and Affiliations

  1. 1.Department of Blood Purification, Institute of Uro-Nephrology, Beijing Chao-Yang HospitalCapital Medical UniversityBeijingChina

Personalised recommendations