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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Ambulatory arterial stiffness index in children after kidney transplantation

Arianna Dégi1, Andrea Kerti, Orsolya Cseprekál

  • 11st Department of Pediatrics, Semmelweis University, Budapest, Hungary.

Pediatric Transplantation
|July 17, 2013
PubMed

Insights

Arterial stiffness (AASI) in children post-kidney transplant is linked to blood pressure dipping, volume overload, and dialysis duration. Increased AASI in hypertensive children reflects current arterial rigidity, unlike long-term changes measured by pulse wave velocity (PWV).

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research
  • Transplantation Medicine

Background:

  • Cardiovascular (CV) morbidity increases post-kidney transplantation (RTx), especially in children where CV events are rare.
  • Arterial stiffness, measured by the augmentation index (AASI), is a key predictor of CV and cerebrovascular events in adults.
  • Surrogate markers are needed to assess CV damage in pediatric RTx recipients.

Purpose of the Study:

  • To determine factors influencing AASI in pediatric RTx patients.
  • To investigate the relationship between AASI and central pulse wave velocity (PWV).
  • To characterize arterial stiffness in hypertensive (HT) pediatric RTx patients.

Main Methods:

  • AASI was calculated from 24-hour ambulatory blood pressure monitoring (ABPM).
  • Central PWV was measured using applanation tonometry.
  • Body composition and extracellular water were assessed via multifrequency bioimpedance.

Main Results:

  • AASI determinants in RTx children included dipping status, volume overload, and dialysis duration (p < 0.05).
  • Hypertensive RTx children showed elevated AASI, extracellular water, and BNP (p < 0.05).
  • PWV did not differ between hypertensive and normotensive groups and showed no correlation with AASI.

Conclusions:

  • Increased AASI in hypertensive pediatric RTx patients reflects acute, volume- and pressure-driven arterial rigidity.
  • PWV, reflecting long-term arterial changes, was elevated only in children with prolonged pre-RTx dialysis.
  • AASI appears to be a more sensitive marker of current arterial status in this population than PWV.

Keywords:
ambulatory arterial stiffness indexcardiovascular risktransplant children

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