Key result
In stable kidney transplant patients, vascular structure and function progressively worsened over 3-6 months, evidenced by a significant 1.52% decrease in flow-mediated dilation.
Why the study?
Kidney transplant patients experience vascular abnormalities and high cardiovascular event rates despite initial improvements, but the longer-term progression of these abnormalities remains unknown.
Does vascular structure and function worsen over time in stable kidney transplant patients compared to healthy controls?
Cohort (n=35)
No
Does vascular structure and function worsen over time in stable kidney transplant patients compared to healthy controls?
Stable kidney transplant patients experience progressive worsening of endothelial function, arterial stiffness, and atherosclerosis over a 3-6 month period, which may contribute to their persistently high cardiovascular risk.
Answers are grounded in this paper and cite their sources.
Progressive endothelial dysfunction in stable kidney transplant patients may signal ongoing CV risk; leaves open whether targeted interventions alter 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. (2019) conducted a cohort in Stable kidney transplant patients (n=35). Long-term post-kidney transplantation state vs. Healthy controls was evaluated on Change in brachial artery flow-mediated dilation (FMD) from baseline to 3-6 months (MD -1.52, p=0.03). In stable kidney transplant patients, vascular structure and function progressively worsened over 3-6 months, evidenced by a significant 1.52% decrease in flow-mediated dilation.
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