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01 June 2010

Factors associated with increased arterial stiffness in renal transplant recipients

Paweł StrozeckiABCDEFG, Andrzej AdamowiczABDEFG, Zbigniew WlodarczykDEG, Jacek ManitiusDEG

Med Sci Monit 2010; 16(6): CR301-306 :: ID: 880614

Abstract

Background: Pulse wave velocity (PWV) is a marker of arterial stiffness. It was shown that PWV is related to increased cardiovascular risk in renal transplant recipients (RTR). Renal transplantation leads to decrease of arterial stiffness when compared with dialysis patients. Despite many studies, causes of increased arterial stiffness in RTR are not well defined. This study sought to investigate the association between cardiovascular risk factors, graft function, cardiovascular and immunosuppressive therapy, and carotid-femoral PWV in renal transplant recipients.
Material/Methods: Carotid-femoral PWV were measured with Complior device in 207 (73 female and 134 male) RTR aged 45±12 years, and in 21 healthy volunteers as controls.
Results: Pulse wave velocity was higher in RTR compared with controls: 9.2±2.1 m/s vs 8.3±1.5m/s (P<.05). In RTR group, significant correlations were found between PWV and age (r=0,55; P<.001), male sex (r=0.17; P<.02), body weight (r=0.23; P<.01), systolic (SBP) (r=0.36; P<.001), and diastolic blood pressure (DBP) (r=0.19; P<.01), pulse pressure (pulse pressure) (r=0.34; P<.001), mean arterial pressure (MAP) (r=0.28; P<.001), number of antihypertensive medication (r=0.17; P<.02), fasting glucose (r=0.24; P<.01), presence of diabetes (r=0.24; P<.01), eGFR (r=–0.19; P<.01), therapy with cyclosporine (r=0.29; P<.001), and therapy with tacrolimus (r=–0.22; P<.01). In stepwise multiple regression analysis, age, male sex, MAP, cyclosporine, and fasting glucose concentration were independently associated with increased PWV.
Conclusions: Arterial stiffness is increased in RTR. Type of immunosuppressive regimen, high blood pressure, and glucose metabolism disturbances should be considered as potential targets to reduce increased arterial stiffness in RTR.

Keywords: Kidney Failure, Chronic - therapy, Immunosuppressive Agents - therapeutic use, Hypertension - etiology, Cyclosporine - therapeutic use, Cross-Sectional Studies, Arteries - physiopathology, Kidney Transplantation - physiology, Regression Analysis

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