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Updated: May 14, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Longitudinal analysis of vascular function and biomarkers of metabolic bone disorders before and after renal
Mahmut Ilker Yilmaz1, Alper Sonmez, Mutlu Saglam
1Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey. mahmutiyilmaz@yahoo.com
Insights
Reversing chronic kidney disease-mineral bone disorder (CKD-MBD) after kidney transplantation improves vascular function. This improvement is linked to lower FGF23, reduced phosphorus, and increased vitamin D, potentially lowering cardiovascular risk.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Chronic kidney disease-mineral bone disorder (CKD-MBD) is a common complication in patients with kidney failure.
- The impact of CKD-MBD reversibility on vascular function post-transplantation remains unclear.
- Cardiovascular disease is a leading cause of mortality in kidney transplant recipients.
Purpose of the Study:
- To investigate the longitudinal relationship between CKD-MBD biomarkers and vascular function after kidney transplantation.
- To determine if CKD-MBD resolution contributes to improved cardiovascular outcomes post-transplant.
Main Methods:
- A cohort of 161 patients with end-stage renal disease on chronic dialysis were studied.
- Vascular function was assessed by flow-mediated dilatation (FMD) before and after kidney transplantation.
- Key CKD-MBD biomarkers including FGF23, 25-hydroxy-vitamin D, and serum phosphate were measured.
Main Results:
- Patients exhibited significantly impaired FMD before transplantation compared to healthy controls.
- Kidney transplantation led to a significant improvement in FMD.
- Changes in FMD were independently associated with fibroblast growth factor 23 (FGF23), 25-hydroxy-vitamin D (25OHVD), and serum phosphate levels.
Conclusions:
- Endothelium-dependent vasodilation improves post-kidney transplantation.
- This improvement correlates with decreased FGF23, reduced serum phosphorus, and increased 25OHVD.
- Partial resolution of CKD-MBD may contribute to the reduced cardiovascular risk observed after kidney transplantation.
Background/Aims:
The role of chronic kidney disease-mineral bone disorder (CKD-MBD) reversibility in the amelioration of vascular function and in the reduction of the risk for cardiovascular events after renal transplantation is still unknown.
Methods:
We investigated the longitudinal relationship between the main biomarkers of CKD-MBD and the evolution of vascular function [flow-mediated dilatation (FMD)] after transplantation in a series of 161 patients with kidney failure maintained on chronic dialysis (5D-CKD).
Results:
Before transplantation, FMD in patients was markedly lower (-40%, p < 0.001) than in well-matched healthy subjects and increased by 27% after transplantation (p = 0.001). Fibroblast growth factor 23 (FGF23), 25-hydroxy-vitamin D (25OHVD) and serum phosphate (p < 0.01) were independently associated with simultaneous changes in FMD. Changes in classical risk factors and in risk factors related to CKD like the glomerular filtration rate, serum albumin, C-reactive protein and insulin resistance failed to independently explain the variability in FMD changes after transplantation.
Conclusion:
Endothelium-dependent vasodilatation improves after kidney transplantation, which is parallel to the dramatic fall in FGF23, the reduction in serum phosphorus and the increase in 25OHVD levels. If these associations are causal, a part of decline in cardiovascular risk after transplantation is related to partial resolution of CKD-MBD.
