Key result
In stable kidney transplant patients, markers of vascular structure and function worsened over 3-6 months, with flow-mediated dilation decreasing by 1.52%, pulse wave velocity increasing by 0.62 m/s, and intima-media thickness increasing by 0.35 mm.
Why the study?
Kidney transplant patients experience vascular abnormalities and elevated cardiovascular event rates despite initial post-transplant improvements, but longer-term progression of these abnormalities remains unknown.
Do markers of vascular structure and function worsen over time in stable kidney transplant patients compared to healthy controls?
Cohort (n=35)
No
Do markers of vascular structure and function worsen over time in stable kidney transplant patients compared to healthy controls?
Markers of vascular structure and function progressively worsen in stable kidney transplant patients on long-term follow-up, potentially explaining their continued high cardiovascular event rates.
Answers are grounded in this paper and cite their sources.
May explain persistent CV risk post-transplant; hypothesis-generating and requires controlled confirmation.
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. Conclusions 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). Post-kidney transplant period vs. Healthy controls was evaluated on Change in brachial artery flow-mediated dilation (FMD) (Mean change -1.52, p=0.03). In stable kidney transplant patients, markers of vascular structure and function worsened over 3-6 months, with flow-mediated dilation decreasing by 1.52%, pulse wave velocity increasing by 0.62 m/s, and intima-media thickness increasing by 0.35 mm.
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