Evolution of arterial stiffness after kidney transplantation

BACKGROUND: Increased arterial stiffness (AS) is a major determinant of cardiovascular complications in end-stage renal disease (ESRD) patients. Little is known about AS evolution after kidney transplantation. The aim of the study was to characterize the evolution of AS after kidney transplantation in a population of ESRD patients, in comparison to those remaining in dialysis. METHODS: Eighty-eight patients (age between 35 and 65) were recruited from the waiting list for kidney transplantation of the University Hospital of Nancy. Two vascular evaluations were performed at a 1-year interval. During this interval, 39 patients were transplanted and 49 remained in dialysis. RESULTS: At inclusion, median pulse-wave velocity (PWV) was similar in transplanted patients and transplantation-pending patients, respectively, 9.2 (7.9-11.9) and 9.8 (7.7-12.1) m/s. No difference between the two groups was found at the 1-year interval. Median of time after transplantation was 6.3 (3.8-10.1) months. Median of blood pressure (MBP) decreased only in the transplanted patients [99 (93-112) versus 96 (90-101) mmHg, P < 0.01] Multivariate analysis showed that PWV changes depend on changes in MBP and baseline PWV. CONCLUSION: Although no difference in the 1-year PWV evolution was found, the low MBP value in transplanted patients allow to expect a better long-term evolution of AS and a better cardiovascular prognosis after kidney transplantation than in transplantation-pending patients.