Inflammation and Atherosclerosis Are Associated With Hypertension in Kidney Transplant Recipients

Abstract

The aim of the current study was to evaluate risk factors associated with hypertension in kidney transplant recipients. The authors recruited 92 consecutive kidney transplant recipients and 30 age‐matched patients with chronic kidney disease without history of cardiovascular events. Twenty‐four–hour ambulatory blood pressure monitoring, pulse wave velocity, and carotid ultrasound were performed. Serum levels of log‐transformed interleukin 6 (Log IL‐6), soluble tumor necrosis factor receptor 2, and intercellular adhesion molecule 1 were determined. Twenty‐four–hour systolic blood pressure (SBP) (P=.0001), Log IL‐6 (P=.011), and total number of carotid plaques (P=.013) were higher, while the percentage decline of SBP from day to night was lower in kidney transplant recipients (P=.003). Independent predictors of 24‐hour SBP were urinary protein/creatinine ratio and circulating monocytes (P=.001), while Log IL‐6, serum creatinine, and total number of carotid plaques (P=.0001) were independent predictors of percentage decline of SBP from day to night. These results suggest that subclinical atherosclerosis and systemic inflammation are associated with hypertension after transplantation.

Arterial Stiffness in Patients With Renal Transplantation; Associations With Co-morbid Conditions, Evolution, and Prognostic Importance for Cardiovascular and Renal Outcomes

“…In contrast to the above, a study by Azancot et al (47) aiming to evaluate risk factors associated with hypertension in renal transplant recipients and included 92 consecutive renal transplant recipients and 30 CKD patients with similar age, sex, renal function, and proteinuria found no significant difference between transplant and CKD patients in intima media thickness (IMT) (0.768 ± 0.139 vs. 0.761 ± 0.126 mm, p = 0.134), PWV (7.98 ± 1.75 vs. 8.17 ± 1.84, P = 0.628), and ankle-brachial pressure index, which was normal in 67 (72.8%) transplant and 20 (66.6%) CKD patients and abnormally high in 21 (22.8%) transplant and 8 (26.6%) CKD patients (47). In another cross-sectional analysis (48), Stróżecki et al attempted to investigate relationship between coronary artery calcification (CAC) and PWV and assess the performance of PWV measurement in predicting CAC.…”

Carbonic Anhydrase 1-Mediated Calcification Is Associated With Atherosclerosis, and Methazolamide Alleviates Its Pathogenesis

“…This cytokine is involved in angiogenesis within AS plaques and is closely associated with AS plaque stability and disease progression (Falk et al, 1995; Chen et al, 1999). IL-6 is secreted by vascular endothelial cells, macrophages, and VSMCs and is involved in the formation and stability of AS plaques (Verma et al, 2002; Schuett et al, 2012; Azancot et al, 2015). The chemoattractant effect of MCP-1 leads to the accumulation of numerous macrophages on artery walls and promotes plaque generation and development (Zeng et al, 2003; Wang et al, 2014).…”

Fatigue in kidney transplant recipients

“…Various dimensions of fatigue assessed through the MFI‐20 (general fatigue, physical fatigue, reduced activity, and reduced motivation) in KTR have been shown to be independently associated with chronic inflammation . Chronic inflammation is common in KTR and similar for frequency and severity to inflammation of chronic kidney disease patients . Fatigue in KTR is significantly associated with symptoms of depression and/or sleep disorders .…”

“…Chronic inflammation is common in KTR and similar for frequency and severity to inflammation of chronic kidney disease patients. [27][28][29] Fatigue in KTR is significantly associated with symptoms of depression and/or sleep disorders. 10,20 However, depressive symptoms could not completely explain the presence of severe fatigue.…”