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Updated: Apr 19, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Bone metabolism and arterial stiffness after renal transplantation
Orsolya Cseprekál1, Eva Kis, Arianna A Dégi
11st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Insights
Kidney transplant recipients show increased bone turnover and arterial stiffness, which improve over time. Arterial stiffness initially relates to bone metabolism but later correlates with cholesterol levels.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Metabolic bone disease (MBD) is prevalent in chronic kidney disease (CKD) and linked to cardiovascular (CV) disease.
- Renal transplantation (Tx) may improve CV disease, but bone disease changes post-Tx are debated.
Purpose of the Study:
- To evaluate the relationship and temporal changes between bone disease and vascular disease after renal transplantation.
Main Methods:
- Assessed bone turnover markers (BALP, OC, beta-crosslaps) and arterial stiffness (pulse wave velocity, PWV) in 47 Tx patients.
- Follow-up duration ranged from 3 to 191 months post-Tx.
Main Results:
- Bone turnover markers were elevated post-Tx but decreased significantly within one year.
- Arterial stiffness (PWV) increased post-Tx.
- Early post-Tx, PWV correlated with bone turnover markers (BALP, beta-crosslaps).
- Later post-Tx (≥24 months), PWV correlated with cholesterol levels.
Conclusions:
- Kidney transplantation is associated with elevated bone turnover and arterial stiffness.
- Bone turnover declines over time post-Tx.
- Arterial stiffness initially tracks with bone turnover, then becomes associated with cholesterol levels.
- Monitoring bone metabolism and arterial stiffness may aid in managing CKD-MBD post-renal transplantation.
Background/Aims:
To assess the relationship between bone and vascular disease and its changes over time after renal transplantation. Metabolic bone disease (MBD) is common in chronic kidney disease (CKD) and is associated with cardiovascular (CV) disease. Following transplantation (Tx), improvement in CV disease has been reported; however, data regarding changes in bone disease remain controversial.
Methods:
Bone turnover and arterial stiffness (pulse wave velocity (PWV)) were assessed in 47 Tx patients (38 (3-191) months after Tx).
Results:
Bone alkaline phosphatase (BALP), osteocalcin (OC) and beta-crosslaps were significantly higher in Tx patients, and decreased significantly after one year. There was a negative correlation between BALP, OC and steroid administered (r = -0.35; r = -0.36 respectively). PWV increased in the Tx group (1.15 SD). In patients with a follow up of <24 months, PWV was correlated with BALP and beta-crosslaps (r=0.53; r = 0.69 respectively) while in the ≥24 months group, PWV was correlated with cholesterol (r=0.38).
Conclusions:
Increased bone turnover and arterial stiffness are present following kidney transplantation. While bone turnover decreases with time, arterial stiffness correlates initially with bone turnover, after which the influence of cholesterol becomes significant. Non-invasive estimation of bone metabolism and arterial stiffness may help to assess CKD-MBD following renal transplantation.
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