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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Arterial elasticity measurement in renal transplant recipients
A Yildiz1, M Fazlioglu, A Ersoy
1Department of Nephrology, Uludag University Medical Faculty, Gorukle, Bursa 16059, Turkey.
Insights
Chronic kidney disease patients on hemodialysis have reduced arterial elasticity. Kidney transplantation improves arterial elasticity in these patients, though small artery elasticity may remain lower than in healthy individuals.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Vascular Physiology
Background:
- Chronic kidney disease (CKD) is associated with diminished arterial distensibility.
- Reduced arterial compliance is a predictor of coronary events in CKD patients.
- Arterial elasticity assessment is crucial for cardiovascular risk stratification in kidney disease.
Purpose of the Study:
- To compare arterial elasticity (large conduit arteries C1, small arteries C2) in hemodialysis (HD) patients, renal transplant recipients (RTR), and healthy subjects.
- To evaluate the impact of kidney transplantation on arterial elasticity in CKD patients.
- To assess differences in arterial elasticity based on immunosuppressive therapy (tacrolimus vs. cyclosporine).
Main Methods:
- Pulse wave analysis was employed to measure large (C1) and small (C2) artery compliances.
- Study included 18 HD patients, 23 RTRs, and 20 healthy control subjects with normal coronary angiograms.
- Comparison of C1 and C2 levels across the three groups and between different immunosuppressants.
Main Results:
- HD patients exhibited significantly lower C1 and C2 levels compared to both RTRs and healthy subjects.
- RTRs demonstrated a lower C2 level compared to healthy subjects, indicating persistent small artery dysfunction.
- No significant difference in C1 or C2 was observed between RTRs treated with tacrolimus versus cyclosporine.
Conclusions:
- Kidney transplantation significantly improves large artery elasticity and partially improves small artery elasticity in CKD patients.
- Hemodialysis is associated with severe impairment of both large and small artery elasticity.
- Arterial elasticity is improved post-transplantation, but small artery compliance may not fully normalize.
Abstract:
Arterial distensibility is reduced in chronic kidney disease (CKD) and after kidney transplantation. Pulse counter analysis provides an assessment of compliance or elasticity of the large conduit arteries (C1) and small arteries (C2). Decreased compliance has been shown to be predictive of primary coronary events in CKD patients. The aim of the present study was to compare elasticity measurements in hemodialysis (HD) patients, renal transplant recipients (RTR), and healthy subjects whose coronary angiographies were without lesion. Twenty-three RTRs, 18 HD patients, and 20 healthy subjects were included in the study. Pulse wave analysis was used to determine large and small vessel compliances. The C1 and C2 levels were significantly lower in HD patients compared with recipients and healthy subjects. Recipients showed lower C2 level compared with healthy subjects. There was no difference in C1 and C2 measurements between recipients receiving tacrolimus versus cyclosporine. Transplantation improves large and to some extend small artery elasticities in CKD patients.
