Arterial stiffness and renal transplantation

Safar, Michel E.; Bahous, Sola Aoun

doi:10.1097/hjh.0b013e328311d223

Cited by 3 publications

(2 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the kidneys, the blood flow is torrential but the vascular resistance to flow is low : A rapid increase in pp after transplantation might thus cause small vascular damage. Although elevated pp is a well‐known predictor of cardiovascular events , the relationship between pp and renal fibrogenesis has not yet been thoroughly explored . Our study suggests that it should, especially in patients durably exposed to CNI.…”

Section: Discussionmentioning

confidence: 84%

Progression of pulse pressure in kidney recipients durably exposed to CsA is a risk factor for epithelial phenotypic changes: an ancillary study of the CONCEPT trial

et al. 2014

View full text Add to dashboard Cite

SummaryIn this ancillary study of the CONCEPT trial, we studied the role of CsA withdrawal at 3 months (3M) post-transplant on the intensity of epithelial phenotypic changes (EPC, an early marker for kidney fibrogenesis) on the 12M surveillance biopsy. Although conversion from CsA to sirolimus (SRL) at 3M was reported to have improved mean graft function at 12M, it did not reduce the score of EPC (1.73 AE 1.15 in the SRL group vs. 1.87 AE 1 in the CsA group, P = 0.61). Acute rejection, which had occurred twice more frequently in SRL-converted patients included here, was associated with 12M EPC. Interestingly, we observed that the patients durably exposed to CsA and who developed 12M EPC had a significant progression of blood pulse pressure (pp) from 1 to 6M post-transplantation (Dpp = +12.3 mmHg, P = 0.0035). Pulse pressure at 4, 6, and 9M and pp progression from 1 to 6M were significantly associated with the development of EPC at 12M in renal grafts. Logistic regression analysis revealed that a high 6M pp (≥60 mmHg) was an independent risk factor for 12M EPC with an odds ratio of 2.25 per additional 10 mmHg pp (95%CI: 1.14-4.4, P = 0.02) after adjustment with recipient's and donor's age, acute rejection incidence and immunosuppressive regimen. A post hoc analysis of the data collected in the whole population CONCEPT study revealed that pp was significantly higher at 6 months in patients maintained on CsA and that at this time point pp correlated negatively with GFR at 1 year. 344

show abstract

Section: Discussionmentioning

confidence: 84%

Progression of pulse pressure in kidney recipients durably exposed to CsA is a risk factor for epithelial phenotypic changes: an ancillary study of the CONCEPT trial

et al. 2014

View full text Add to dashboard Cite

show abstract

“…24 In renal transplant recipients, endothelial dysfunction is well documented, and leads to functional and structural changes that influence arterial stiffness. 25,26 Arterial stiffness, assessed by pulse wave velocity, is present in renal transplant recipients, and is enhanced by the use of calcineurin inhibitors. 27,28 Owing to the pre-existing endothelial dysfunction, renal transplant recipients are at high risk for deleterious effect of inhibitors of NO, such as ADMA.…”

Section: Discussionmentioning

confidence: 99%

Asymmetrical dimethylarginine is associated with renal and cardiovascular outcomes and all-cause mortality in renal transplant recipients

Abedini¹,

Meinitzer

Holme

et al. 2010

Kidney International

View full text Add to dashboard Cite

Increased plasma levels of asymmetric dimethylarginine (ADMA) are associated with endothelial dysfunction and predict the progression to dialysis and death in patients with chronic kidney disease. The effects of these increased ADMA levels in renal transplant recipients, however, are unknown. We used the data from ALERT, a randomized, double-blind, placebo-controlled study of the effect of fluvastatin on cardiovascular and renal outcomes in 2102 renal transplant recipients with stable graft function on enrollment. Patients who were initially randomized to fluvastatin or placebo in the 5- to 6-year trial were offered open-label fluvastatin in a 2-year extension of the original study. After adjustment for baseline values for established factors in this post hoc analysis, ADMA was found to be a significant risk factor for graft failure or doubling of serum creatinine (hazard ratio 2.78), major cardiac events (hazard ratio 2.61), cerebrovascular events (hazard ratio 6.63), and all-cause mortality (hazard ratio 4.87). In this trial extension, the number of end points increased with increasing quartiles of plasma ADMA levels. All end points were significantly increased in the fourth compared to the first quartile. Our study shows that elevated plasma levels of ADMA are associated with increased morbidity, mortality, and the deterioration of graft function in renal transplant recipients.

show abstract

Cardiovascular and renal outcome in recipients of kidney grafts from living donors: role of aortic stiffness

Bahous

Stephan

Blacher

et al. 2011

Nephrology Dialysis Transplantation

View full text Add to dashboard Cite

show abstract

Arterial stiffness and renal transplantation

Cited by 3 publications

References 10 publications

Progression of pulse pressure in kidney recipients durably exposed to CsA is a risk factor for epithelial phenotypic changes: an ancillary study of the CONCEPT trial

Progression of pulse pressure in kidney recipients durably exposed to CsA is a risk factor for epithelial phenotypic changes: an ancillary study of the CONCEPT trial

Asymmetrical dimethylarginine is associated with renal and cardiovascular outcomes and all-cause mortality in renal transplant recipients

Cardiovascular and renal outcome in recipients of kidney grafts from living donors: role of aortic stiffness

Contact Info

Product

Resources

About