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Updated: Nov 2, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Less arterial stiffness in kidney transplant recipients than chronic kidney disease patients matched for renal
Lynda Cheddani1,2, Jean Philippe Haymann3,4, Sophie Liabeuf5,6
1Université Paris Saclay (Paris Sud et Versailles Saint Quentin en Yvelines), INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), France.
Insights
Kidney transplant recipients (KTRs) show reduced aortic stiffness one year post-transplant compared to chronic kidney disease patients (CKDps). This suggests different cardiovascular disease pathways in KTRs versus CKD.
Area of Science:
- Cardiovascular Science
- Nephrology
- Transplantation Medicine
Background:
- Chronic kidney disease (CKD) presents a significant cardiovascular risk.
- Kidney transplant recipients (KTRs) face a higher global mortality risk than matched CKD patients.
- Aortic stiffness, measured by carotid-femoral pulse wave velocity (CF-PWV), is a key cardiovascular risk indicator.
Purpose of the Study:
- To compare aortic stiffness (CF-PWV) in KTRs versus CKD patients with similar measured glomerular filtration rates (mGFR).
- To evaluate cardiovascular risk factors associated with arterial stiffness in these patient groups.
Main Methods:
- Two cohorts, TransplanTest (KTRs) and NephroTest (CKDps), were analyzed for CF-PWV.
- Propensity score matching was used, considering mGFR, age, sex, mean blood pressure (MBP), body mass index (BMI), and heart rate.
- Logistic regression identified factors associated with high arterial stiffness (CF-PWV > 10.6 m/s).
Main Results:
- At 12 months post-transplant, KTRs exhibited significantly lower CF-PWV (10.1 m/s) than CKDps (11.0 m/s).
- The prevalence of high arterial stiffness was lower in KTRs (38.0%) compared to CKDps (57.1%).
- High arterial stiffness was linked to lower mGFR, older age, higher BMI, higher MBP, diabetes, and elevated parathyroid hormone levels.
Conclusions:
- Aortic stiffness is significantly reduced in KTRs one year after transplantation compared to GFR-matched CKD patients.
- These findings suggest distinct pathophysiological mechanisms for cardiovascular disease in KTRs compared to CKD.
- This highlights potential benefits of kidney transplantation in mitigating cardiovascular risk.
Background:
Chronic kidney disease is associated with a high cardiovascular risk. Compared with glomerular filtration rate-matched CKD patients (CKDps), we previously reported a 2.7-fold greater risk of global mortality among kidney transplant recipients (KTRs). We then examined aortic stiffness [evaluated by carotid-femoral pulse wave velocity (CF-PWV)] and cardiovascular risk in KTRs compared with CKDps with comparable measured glomerular filtration rate (mGFR).
Methods:
We analysed CF-PWV in two cohorts: TransplanTest (KTRs) and NephroTest (CKDps). Propensity scores were calculated including six variables: mGFR, age, sex, mean blood pressure (MBP), body mass index (BMI) and heart rate. After propensity score matching, we included 137 KTRs and 226 CKDps. Descriptive data were completed by logistic regression for CF-PWV values higher than the median (>10.6 m/s).
Results:
At 12 months post-transplant, KTRs had significantly lower CF-PWV than CKDps (10.1 versus 11.0 m/s, P = 0.008) despite no difference at 3 months post-transplant (10.5 versus 11.0 m/s, P = 0.242). A lower occurrence of high arterial stiffness was noted among KTRs compared with CKDps (38.0% versus 57.1%, P < 0.001). It was especially associated with lower mGFR, older age, higher BMI, higher MBP, diabetes and higher serum parathyroid hormone levels. After adjustment, the odds ratio for the risk of high arterial stiffness in KTRs was 0.40 (95% confidence interval 0.23-0.68, P < 0.001).
Conclusions:
Aortic stiffness was significantly less marked in KTRs 1 year post-transplant than in CKDps matched for GFR and other variables. This observation is compatible with the view that the pathogenesis of post-transplant cardiovascular disease differs, at least in part, from that of CKD per se.
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