Key result
Pediatric patients on dialysis have worse arterial function than transplant patients and controls, with group status independently associated with FMD (β=3.15, p=0.002).
Why the study?
Does renal transplantation improve arterial structure and function compared to dialysis in pediatric patients with end-stage renal disease?
Observational (n=44)
Does renal transplantation improve arterial structure and function compared to dialysis in pediatric patients with end-stage renal disease?
Effect estimate: β = 3.15
p-value: p=0.002
Renal transplantation in pediatric patients with end-stage renal disease is associated with stabilized or improved arterial structure and function compared to maintenance dialysis.
Transplantation may partially improve vascular function in pediatric CKD; leaves open reversibility and need for longitudinal trials.
CVD is a major cause of morbidity and mortality in pediatric patients with CKD. It is unclear whether vascular abnormalities in these patients are reversible, and if transplantation portends salutary effects on arterial function. We compared FMD, PWV, AI75, and CIMT in 15 dialysis (D), 14 transplant patients (T), and 15 controls (C), and their associations with cardiovascular risk factors. There was stepwise lower FMD (p < 0.001), higher AI75 (p < 0.001), higher PWV (p = 0.01), and higher CIMT SDS for age (p = 0.03) and height (p = 0.006) in the D group than T and C groups. FMD, PWV, and CIMT were unrelated to dialysis duration or time from transplantation. On multivariate analysis, group status was independently associated with FMD (β = 3.15, p = 0.002), AI75 (β = -5.95, p = 0.01), PWV (β = -0.57, p = 0.07) and CIMT (β = -0.02, p = 0.04) and CIMT SDS for height (β = -0.541, p = 0.009). FMD is lower and AI75, PWV and CIMT are higher in pediatric patients maintained on D than T/C. T patients have similar AI75, PWV and CIMT to C although FMD remains reduced. These findings suggest that transplantation stabilizes or improves CKD associated arteriopathy.
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Tawadrous et al. (2012) conducted an observational in End-stage renal disease (CKD) (n=44). Dialysis or renal transplantation vs. Controls was evaluated on Flow-mediated dilation (FMD) (β = 3.15, p=0.002). Pediatric patients on dialysis have worse arterial function than transplant patients and controls, with group status independently associated with FMD (β=3.15, p=0.002).
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