Related Experiment Video
Updated: Apr 7, 2026
Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Assessment of arterial stiffness using pulse wave velocity in tacrolimus users the first year post kidney
Kelly Ann Birdwell1, Gilad Jaffe2, Aihua Bian3
1Division of Nephrology and Hypertension, Vanderbilt University Medical Center, 1161 21st Avenue, S-3223 MCN, Nashville, TN, 37232, USA. kelly.birdwell@vanderbilt.edu.
Insights
Kidney transplant recipients showed no significant change in arterial stiffness within the first year. Age, diabetes, and baseline stiffness predict future arterial stiffness in these patients.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Cardiovascular disease (CVD) is the primary cause of mortality in end-stage renal disease (ESRD).
- Kidney transplantation improves survival rates compared to dialysis.
- Arterial stiffness is a key indicator of CVD.
Purpose of the Study:
- To investigate the impact of kidney transplantation on arterial stiffness.
- To determine if improvements in arterial stiffness contribute to the survival benefits observed post-transplant.
Main Methods:
- A prospective cohort study involving 66 adult kidney transplant recipients.
- Aortic pulse wave velocity (PWV) was measured at baseline (within 1 month) and 12 months post-transplant.
- Statistical analysis included the Wilcoxon Signed Rank test for primary outcome and multivariable regression for secondary analyses.
Main Results:
- The median PWV score showed no significant change from baseline (9.25 m/s) to 12 months post-transplant (8.97 m/s).
- Increased age at transplant, presence of diabetes, and higher baseline PWV were associated with increased arterial stiffness at 12 months.
- Key demographic factors included a median age of 49.7 years, with 27% Black and 27% female participants.
Conclusions:
- Arterial stiffness does not progress in the first year following kidney transplantation.
- Age, diabetes, and baseline arterial stiffness are predictors of future stiffness in kidney transplant recipients.
- Further long-term studies with a dialysis control group are needed to fully understand arterial stiffness changes post-transplantation.
Background:
The leading cause of death in end stage renal disease is cardiovascular disease (CVD). Kidney transplantation is associated with improved survival over dialysis. We hypothesized that arterial stiffness, a marker of CVD, would improve in patients post kidney transplant, potentially explaining one mechanism of survival benefit from transplant.
Methods:
After obtaining Institutional Review Board approval and informed consent, we performed a longitudinal prospective cohort study of 66 newly transplanted adult kidney transplant recipients, using aortic pulse wave velocity (PWV) to assess arterial stiffness over a 12 month period. All patients were assessed within one month of transplant (baseline) and 12 months post transplant. The primary outcome was change in PWV score at 12 months which we assessed using Wilcoxon Signed Rank test. Secondary analyses included correlation of predictors with PWV score at both time points.
Results:
The median age of the cohort was 49.7 years at transplant, with 27 % Black and 27 % female. At baseline, 43 % had tobacco use, 30 % had a history of CVD, and 42 % had diabetes. Median baseline calcium was 9.1 mg/dL and median phosphorus was 5.1 mg/dL. Median PWV score was 9.25 and 8.97 m/s at baseline versus month 12, respectively, showing no significant change (median change of -0.07, p = 0.7). In multivariable regression, subjects with increased age at transplant (p = 0.008), diabetes (p = 0.002), and a higher baseline PWV score (p < 0.001) were at increased risk of having a high PWV score 12 months post transplant.
Conclusion:
Aortic arterial stiffness does not progress in the first year post kidney transplant. Increasing age, diabetes, and higher baseline PWV score identify patients at risk for increased arterial stiffness. Further research that assesses patients for greater than one year and includes a control dialysis group would be helpful in further understanding the change in arterial stiffness post transplantation.
Related Concept Videos
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
01:23Assessment of blood pressure in brachial artery(two-step method)
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation