Key result
In stable kidney transplant patients, vascular function significantly worsened over 3-6 months, evidenced by a 1.52% decrease in flow-mediated dilation and increases in arterial stiffness and intima-media thickness.
Why the study?
Kidney transplant patients experience vascular abnormalities and high cardiovascular event rates despite initial post-transplant improvements, but longer-term progression of these vascular abnormalities remains unknown.
Cohort (n=35)
No
Markers of vascular structure and function, including endothelial dysfunction and arterial stiffness, progressively worsen in stable kidney transplant patients during long-term follow-up.
Answers are grounded in this paper and cite their sources.
May support vascular monitoring in stable kidney transplant recipients; leaves open whether targeted interventions alter cardiovascular outcomes.
BACKGROUND: Kidney transplant patients suffer from vascular abnormalities and high cardiovascular event rates, despite initial improvements post-transplantation. The nature of the progression of vascular abnormalities in the longer term is unknown. This pilot study investigated changes in vascular abnormalities over time in stable kidney transplant patients long after transplantation. METHODS: Brachial artery flow-mediated dilation (FMD), nitroglycerin-mediated dilation, carotid-femoral pulse wave velocity (cf-PWV), ankle-brachial pressure index, and common carotid artery intima-media thickness (CCA-IMT) were assessed in 18 kidney transplant patients and 17 controls at baseline and 3-6 months after. RESULTS: There was no difference in age (51 ± 13 vs. 46 ± 11; P = 0.19), body mass index (26 ± 5 vs. 25 ± 3; P = 0.49), serum cholesterol (4.54 ± 0.96 vs. 5.14 ± 1.13; P = 0.10), systolic blood pressure (BP) (132 ± 12 vs. 126 ± 12; P = 0.13), diastolic BP (82 ± 9 vs. 77 ± 8; P = 0.10), or diabetes status (3 vs. 0; P = 0.08) between transplant patients and controls. No difference existed in vascular markers between patients and controls at baseline. In transplant patients, FMD decreased (- 1.52 ± 2.74; P = 0.03), cf-PWV increased (0.62 ± 1.06; P = 0.03), and CCA-IMT increased (0.35 ± 0.53; P = 0.02). No changes were observed in controls. CONCLUSION: Markers of vascular structure and function worsen in the post-transplant period on long-term follow-up, which may explain the continued high cardiovascular event rates in this population.
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Junarta et al. (2020) conducted a cohort in Stable kidney transplant patients (n=35). Post-kidney transplant period vs. Healthy controls was evaluated on Change in brachial flow-mediated dilation (FMD) (p=0.03). In stable kidney transplant patients, vascular function significantly worsened over 3-6 months, evidenced by a 1.52% decrease in flow-mediated dilation and increases in arterial stiffness and intima-media thickness.
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