Assessment of endothelial dysfunction in Asian Indian patients with chronic kidney disease and changes following renal transplantation

Sharma, Jai Prakash; Kapoor, Aditya; Muthu, Ranjanee; Prasad, Narayan; Sinha, Archana; Khanna, Roopali; Kumar, Sudeep; Garg, Naveen; Tewari, Satyendra; Sharma, Raj Kumar; Goel, Pravin K.

doi:10.1111/ctr.12398

Cited by 16 publications

(22 citation statements)

References 44 publications

(54 reference statements)

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“…Baseline transferrin was associated with changes in cf-PWV while baseline phosphate was associated with changes in CCA-IMT. CKD patients exhibit endothelial dysfunction as measured by FMD [3,5]. In previous studies, transplantation has been shown to improve FMD, acutely and at 12 months [14,15].…”

Section: Discussionmentioning

confidence: 95%

“…This recovery may be due to improvements in traditional and uraemia-related non-traditional risk factors [6]. Despite this, FMD values were often still lower compared to controls [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, we found baseline corrected calcium to be associated with changes in FMD and baseline phosphate to be associated with changes in CCA-IMT. Studies have described progressively decreasing FMD with greater renal impairment [3,5]. Improvements in eGFR after transplantation can explain improvements in FMD in the newly transplanted.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, they promote intravascular fibrosis and cause sodium retention leading to hypertension [30]. Hence, these unwanted effects from immunosuppressants may impair endothelial function and promote arterial stiffness in the long run [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…Endothelial dysfunction, arterial stiffness, and accelerated atherosclerosis are common in stable kidney transplant patients and may contribute to the high cardiovascular event rate [3,5,6]. Endothelial dysfunction, a prerequisite to atherosclerosis, encompasses numerous maladaptive alterations adversely affecting vascular tone, haemostasis, and inflammatory processes within the arterial wall [7].…”

Section: Introductionmentioning

confidence: 99%

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Progression of endothelial dysfunction, atherosclerosis, and arterial stiffness in stable kidney transplant patients: a pilot study

Junarta

Hojs

Ramphul

et al. 2020

BMC Cardiovasc Disord

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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 followup, which may explain the continued high cardiovascular event rates in this population.

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Section: Discussionmentioning

confidence: 95%

“…This recovery may be due to improvements in traditional and uraemia-related non-traditional risk factors [6]. Despite this, FMD values were often still lower compared to controls [5,6].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%