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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Endothelial Dysfunction and 6-Year Risk of Mortality in Kidney Transplant Recipients.
Nina Elisabeth Langberg1,2, Trond G Jenssen1,2, Anders J Haugen1,2
1Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Transplantation Direct
|December 16, 2021
Summary
Impaired endothelial function, measured by flow-mediated dilation (FMD), is a significant predictor of mortality in kidney transplant recipients (KTRs). Lower FMD levels strongly correlate with increased risk of death and graft loss in KTRs.
Area of Science:
- Cardiovascular Science
- Nephrology
- Transplantation Medicine
Background:
- Endothelial dysfunction is an early, potentially reversible stage of atherosclerosis.
- Kidney transplant recipients (KTRs) are susceptible to endothelial dysfunction.
- Assessing endothelial function noninvasively can inform prognosis in KTRs.
Purpose of the Study:
- To assess endothelial dysfunction noninvasively in KTRs.
- To evaluate the association between endothelial dysfunction and mortality.
- To determine the relationship between endothelial dysfunction and graft outcomes.
Main Methods:
- Flow-mediated dilation (FMD) of the brachial artery was measured using ultrasound.
- Baseline and maximal arterial diameters were recorded during reactive hyperemia.
- Cox regression with restricted cubic splines analyzed risk distribution according to FMD levels.
Main Results:
- Impaired FMD (≤5.36%) was strongly associated with increased mortality (HR 9.80, P=0.03).
- Lower FMD levels correlated with higher risk of uncensored graft loss (HR 7.80, P=0.01).
- The association with death-censored graft loss was not significant after adjusting for pulse pressure.
Conclusions:
- Impaired endothelial function, indicated by reduced FMD, is a potent predictor of mortality in KTRs.
- FMD measurement is a valuable tool for risk stratification in kidney transplant recipients.
- Early detection of endothelial dysfunction may guide interventions to improve KTR outcomes.
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