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Effect of renal transplantation on endothelial function in haemodialysis patients

Huseyin Kocak1, Kaan Ceken, Asuman Yavuz

  • 1Department of Nephrology, Akdeniz University School of Medicine, Kampus 07070, Antalya, Turkey. hkocak@akdeniz.edu.tr

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|September 8, 2005
PubMed

Insights

Renal transplantation (RTx) significantly improves endothelial function in haemodialysis (HD) patients by enhancing flow-mediated dilatation (FMD). This suggests that eliminating uraemic toxins through successful RTx may reduce cardiovascular risk in HD patients.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Vascular Biology

Background:

  • Haemodialysis patients exhibit high rates of atherosclerotic cardiovascular disease, not fully explained by traditional risk factors.
  • Uraemic toxins are implicated in endothelial dysfunction, a key factor in atherosclerosis development in this population.
  • Endothelial dysfunction may play a pivotal role in the progression of atherosclerosis in haemodialysis patients.

Purpose of the Study:

  • To investigate the impact of renal transplantation (RTx) on endothelial function in haemodialysis (HD) patients.
  • To assess if the elimination of uraemic toxins post-RTx improves endothelial function, measured by brachial artery flow-mediated dilatation (FMD).

Main Methods:

  • Assessed endothelial function using FMD and glyceryltrinitrate-induced dilatation (NMD) in 30 chronic HD patients before and after RTx.
  • Studied 20 age- and gender-matched healthy controls.
  • Patients selected had no known atherosclerotic disease or traditional cardiovascular risk factors.

Main Results:

  • Flow-mediated dilatation (FMD) significantly improved after RTx in HD patients (6.69% to 10.50%, P<0.001).
  • FMD remained lower in HD patients post-RTx compared to healthy controls (10.50% vs 14.02%, P<0.01).
  • Nitroglycerin-mediated dilatation (NMD) showed no significant change after RTx and was similar to controls.

Conclusions:

  • Successful renal transplantation improves endothelial function, specifically FMD, in haemodialysis patients.
  • The elimination of uraemic toxins following RTx is likely responsible for the observed improvement in endothelial function.
  • Further research into managing vascular risk in HD patients is warranted.
Abstract

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