Organic and functional evaluation of atherosclerosis in renal transplant recipients

We evaluated atherosclerotic lesions in 18 renal transplant recipients in whom the grafts remained functional after transplantation from living donors at the Sakai Hospital, Kinki University School of Medicine. In each patient, the mean intima-media thickness of the bilateral common carotid arteries (mIMT) was measured by ultrasonography. In the pulse wave test, the ankle brachial index (ABI) and the brachial-ankle pulse wave velocity (ba-PWV) were measured. In 12 (66.7%) of the 18 renal transplant recipients examined, the mean value of ba-PWV was higher than the mean plus 1 standard deviation (SD) in the corresponding Japanese age group. A significant correlation was noted between mIMT (an organic indicator of atherosclerosis) and ba-PWV (a functional indicator of atherosclerosis). The age at the time of test, blood pressure and the pre-transplant duration of hemodialysis had a significant positive correlation with both mIMT and ba-PWV. Thus in renal transplant recipients, organic evaluation of atherosclerosis correlated significantly with its functional evaluation. Both evaluations were proven to be reliable. Many of the renal transplant recipients had complications from atherosclerosis, and several factors seemed to be involved in the onset of atherosclerosis in these patients. Among others, the duration of hemodialysis before transplant correlated particularly closely with post-transplant onset of atherosclerosis, and it seems likely that persistent uremia can stimulate the progression of atherosclerosis.