Age-related and blood pressure-independent reduction in aortic stiffness after kidney transplantation

Ignace, Sophie; Utescu, Mihai Silviu; Serres, Sacha A. De; Marquis, Karine; Gaudreault-Tremblay, Marie-Michèle; Lariviere, Richard W.; Côté, Isabelle; Houde, Isabelle; Lebel, Marcel; Agharazii, Mohsen

doi:10.1097/hjh.0b013e32833f5e68

Cited by 37 publications

(41 citation statements)

References 34 publications

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“…Our study was different in that it followed incident patients from time of transplant, with measurements at baseline and one year, adding further information about what happens to PWV over time. Our results indicate that changes in aortic stiffness may be slowed with successful transplantation, consistent with two previous smaller studies over a shorter time period of 3 months [20, 21]. In the study by Ignace, et al aortic stiffness changes post transplantation were dependent on age, with improvement seen only in transplant recipients older than 50 years [21].…”

Section: Discussionsupporting

confidence: 90%

Assessment of arterial stiffness using pulse wave velocity in tacrolimus users the first year post kidney transplantation: a prospective cohort study

et al. 2015

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BackgroundThe 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.MethodsAfter 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.ResultsThe 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.ConclusionAortic 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.

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Section: Discussionsupporting

confidence: 90%

Assessment of arterial stiffness using pulse wave velocity in tacrolimus users the first year post kidney transplantation: a prospective cohort study

et al. 2015

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“…BP was recorded six times, with a 2 min interval between each measurement, and the average of the last five measurements was used to determine the brachial systolic and diastolic BP (DBP) [26]. We determined carotid-femoral pulse wave velocity (cf-PWV) using Complior ® SP (Artech Medical, PantinFrance) as described previously [27,28]. Briefly, the sensors were positioned over carotid and femoral arteries and the transit times were measured.…”

Section: Arterial Parametersmentioning

confidence: 99%

The impact of warfarin on the rate of progression of aortic stiffness in hemodialysis patients: a longitudinal study

Poulin

Utescu

Serres

et al. 2014

Nephrology Dialysis Transplantation

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“…Furthermore, a study of stage 5 CKD patients showed improvement in arterial compliance by reduction in PWV and AIx, at 3 months after kidney transplant [34], suggesting a possible cause-effect relationship between impaired renal function and arterial stiffness. While the reductions in AIx were comparable, patients older than 50 years of age appeared to have more pronounced reduction in PWV than the younger patients.…”

Section: Central Arterial Compliance Measurements and Outcomes In Ckdmentioning

confidence: 97%

Central BP Monitoring, Home BP Monitoring, Ambulatory BP Monitoring in CKD

Cohen

Huan

Townsend

2014

Chronic Kidney Disease and Hypertension

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Hypertension is common among patients with chronic kidney disease (CKD) and the prevalence of hypertension increases as overall kidney function deteriorates, ranging from 60 to 100 % depending on the population studied [1]. This chapter will specifically discuss the role of central blood pressure (BP) monitoring, home BP monitoring (HBPM), and ambulatory BP monitoring (ABPM) in the CKD population. Central BP Monitoring in CKDFor over a century, the gold standard for BP measurement has been the peripheral brachial BP by conventional sphygmomanometry. Despite being a traditional predictor of cardiovascular (CV) risk [2], peripheral brachial BP does not accurately represent central aortic pressure which is intuitively more relevant to the true BP burden experienced by the major organs. While the mean and diastolic BP remain mostly unchanged, the systolic BP and pulse pressure (the difference between the systolic and diastolic BP) are amplified from the aortic root to the peripheral brachial artery. Central aortic BP and arterial compliance can now be reliably assessed using noninvasive applanation tonometry [3] and the reproducibility of these measurements has been confirmed in the CKD population [4][5][6]. Emerging data suggest that measurements of central aortic BP and arterial compliance may be more robust

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Age-related and blood pressure-independent reduction in aortic stiffness after kidney transplantation

Abstract: This study shows for the first time that there is an age-dependent improvement in aortic stiffness after KTx. These observations suggest that older patients may have an added cardiovascular risk reduction after a successful KTx.

Cited by 37 publications

References 34 publications

Assessment of arterial stiffness using pulse wave velocity in tacrolimus users the first year post kidney transplantation: a prospective cohort study

Assessment of arterial stiffness using pulse wave velocity in tacrolimus users the first year post kidney transplantation: a prospective cohort study

The impact of warfarin on the rate of progression of aortic stiffness in hemodialysis patients: a longitudinal study

Central BP Monitoring, Home BP Monitoring, Ambulatory BP Monitoring in CKD

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