A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

Abstract

The mechanisms responsible for reduced arterial distensibility in renal transplant recipients remain to be evaluated. The present longitudinal study was aimed to evaluate the effect of hypertension on the evolution of vessel wall properties in renal transplant recipients. The mechanical properties of the common carotid artery were determined in 24 normotensive and 24 treated hypertensive renal transplant recipients 6-12 weeks after transplantation. The measurements were repeated after 2 years. Arterial distension was determined by using a multigate pulsed Doppler system, blood pressure (BP) was measured by a mercury sphygmomanometer. BP was 127 ؎ 3/80 ؎ 2 mm Hg at entry and 133 ؎ 3/82 ؎ 2 mm Hg after 2 years in the normotensive group, 146 ؎ 4/90 ؎ 3 mm Hg at entry and 145 ؎ 3/87 ؎ 2 mm Hg after 2 years in the hypertensive group (P Ͻ 0.01, normotensives vs hypertensives). The distens-

Arterial stiffness and renal transplantation

“…These results showed that the impact of kidney transplantation on recipient aortic stiffness is dependent on the donor age and suggested that ongoing damage to large arteries might contribute to the mechanism underlying the association of old donor kidneys and increased cardiovascular mortality. Such findings are consistent with those indicating that reduced carotid distensibility predicts cardiovascular complications in patients after renal transplantation [9]. Taken together, all these results indicate that aortic stiffness is increased in kidney transplant recipients irrespective of whether the graft is harvested from deceased or living donors.…”

“…This could suggest that analysis obtained from the 10 patients included in the cyclosporine arm may not be truly representative of what generally happens. Furthermore, it is well established that in the same subject, the affinity and binding of cyclosporine may modify the drug effect differently in the various vascular tissues [2,3,9]. Therefore, as the authors recognize, all these difficulties do not allow these results to be regarded as providing indisputable evidence for a protective effect of everolimus.…”

Studies on cardiac sympathovagal balance and large artery distensibility in patients with untreated essential hypertension

“…In contrast to the results in hypertensive patients with end-stage renal disease, 20,21 recent studies in essential hypertension indicate that higher distending pressure rather than structural alterations may account for arterial stiffness in essential hypertension. 22,23 The effects of sympathetic stimulation on arterial mechanical properties are complex and depend on passive effects of the increased arterial pressure and of changes in vessel geometry and smooth muscle tone due to active vasoconstriction.…”

Abnormal Carotid Artery Structure and Function in Children and Adolescents With Successful Renal Transplantation

“…4,5,[13][14][15] Clinical studies have shown that increased IMT and stiffness of the large arteries independently predict cardiovascular morbidity and mortality in adults with ESRD. 16,17 Recently, these abnormalities have been demonstrated in young adults who developed ESRD during childhood.…”