Prediction of Cardiovascular Events After Renal Transplantation

Seibert, Felix S.; Behrendt, Carolin; Pagonas, Nikolaos; Bauer, Frederic; Kiziler, F.; Zidek, Walter; Westhoff, Timm H.

doi:10.1016/j.transproceed.2014.12.014

Cited by 12 publications

(7 citation statements)

References 37 publications

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“…In ESRD patients, PWV-assessed arterial stiffness is a recommended procedure in CVD risk assessment. 3 In a prospective study, Seibert et al 15 showed during a 52-month follow-up of 64 RTRs that there was a significant correlation between PWV and CVD appearance (10.1 ± 3.6 m/s in patients reaching the endpoint vs 8.5 ± 1.5 m/s in patients not reaching the endpoint; P = 0.048), where the endpoint was defined as the incidence of either death, myocardial infarction, stroke, or admission for symptomatic intermittent claudication or decompensated congestive heart failure. Interestingly, aortic SBP (115 ± 28 vs 118.7 mm Hg; P = 0.635), peripheral SBP (130.5 ± 29.9 vs 131.7 ± 17 mm Hg; P = 0.408), and pulse pressure (62.3 ± 17.3 vs 56.8 ± 12.1 mm Hg; P = 0.128) did not show any significant correlation with CVD appearance.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Arterial Stiffness, Volume, and Nutritional Status in Stable Renal Transplant Recipients

et al. 2016

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Reduction of cardiovascular death might have a significant effect on the long-term survival rates of renal transplant recipients (RTRs). The aim of the study was to assess the relation between arterial stiffness and graft function, adipose tissue content, and hydration status in patients after kidney transplantation (KTx).The study included 83 RTR patients (mean age: 55 ± 13 years) who had been admitted to a nephrology-transplantation outpatient clinic 0.5 to 24 years after KTx. Clinical and laboratory data were analyzed and eGFR was calculated with the CKD-EPI formula. Arterial stiffness was assessed in all RTRs with pulse wave propagation velocity (PWV) with the use of a complior device. In addition, fluid and nutritional status was assessed with a Tanita BC 418 body composition analyzer. The control group consisted of 31 hospital workers who received no medication and had no history of cardiovascular disease.Multivariable linear regression analysis, with PWV as a dependent variable, retained the following independent predictors in the final regression model: red blood cell distribution width (RDW) (B = 0.323; P = 0.004), age (B = 0.297; P = 0.005), tacrolimus therapy (B = −0.286; P = 0.004), and central DBP (B = 0.185; P = 0.041). Multivariable linear regression analysis with eGFR as a dependent variable retained the following independent predictors in the final regression model; creatinine concentration (B = −0.632; P = 0.000), hemoglobin (B = 0.280; P = 0.000), CRP (B = −0.172; P = 0.011), tacrolimus therapy (B = 0.142; P = 0.039), and triglycerides (B = −0.142; P = 0.035).Our data indicates that: kidney transplant recipients can present modifiable CVD risk factors linked to increased arterial stiffness, DBP, waist circumference, SCr, time on dialysis, CyA therapy, and visceral fat mass; RDW is a parameter associated with arterial stiffness; and parameters such as CyA therapy, time on dialysis, PWV, RDW, and triglycerides show negative associations with the allograft function assessed with eGFR.

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Section: Discussionmentioning

confidence: 99%

Assessment of Arterial Stiffness, Volume, and Nutritional Status in Stable Renal Transplant Recipients

et al. 2016

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“…45 The acute influence of calcineurin inhibitor levels on arterial elasticity has also been postulated. 46 Although PWV was measured at the same time of day, individual patient calcineurin inhibitor ingestion time was not monitored. The possibility that there was technical error associated with the measurement technique also cannot be ruled out, although this would have been likely to affect all 3 groups equally.…”

Section: Discussionmentioning

confidence: 99%

Aerobic or Resistance Training and Pulse Wave Velocity in Kidney Transplant Recipients: A 12-Week Pilot Randomized Controlled Trial (the Exercise in Renal Transplant [ExeRT] Trial)

Greenwood

Koufaki

Mercer

et al. 2015

American Journal of Kidney Diseases

121

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“…11 Nevertheless, PWV continues to be an important prognostic factor for mortality, cardiovascular events and loss of graft function during the transplantation period. [20][21][22][23] A recent study pointed out that the initial BP-dependent de-stiffening of aorta following renal transplantation may later be counterbalanced by overactivation of the immune system. 12 Our finding that two thirds of recipients still had hypertension, and that reductions in PWV and ambulatory BP are related, suggests more caution concerning withdrawal of antihypertensive medication and use of AMBP to secure optimal BP control.…”

Section: Renal Transplant Recipientsmentioning

confidence: 99%

Influence of Renal Transplantation and Living Kidney Donation on Large Artery Stiffness and Peripheral Vascular Resistance

Buus

Carlsen

Hughes

et al. 2019

American Journal of Hypertension

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Background Vascular status following renal transplantation (RT) may improve while living kidney donation (LKD) is possibly associated with an increased cardiovascular risk. Methods We prospectively assessed glomerular filtration rate (mGFR, 51Chrome EDTA clearance) and intermediate vascular risk factors in terms of blood pressure (BP), pulse wave velocity (PWV), central augmentation index (AIx), excess pressure (Pexcess), and forearm vascular resistance in donors (n = 58, 45 ± 13 years) and recipients (n = 51, 50 ± 12 years) before and one year following LKD or RT. Results After kidney donation, mGFR decreased by 33% to 65 ± 11 ml/min/1.73m2, while recipients obtained a mGFR of 55 ± 9 ml/min/1.73m.2 Ambulatory 24-hour mean arterial BP (MAP) remained unchanged in donors but decreased by 5 mm Hg in recipients (P < 0.05). Carotid-femoral PWV increased by 0.3 m/s in donors (P < 0.05) but remained unchanged in recipients. AIx was unaltered after LKD but decreased following RT (P < 0.01), and Pexcess did not change in either group. Resting forearm resistance (Rrest), measured by venous occlusion plethysmography, increased after LKD (P < 0.05) but was unaffected by RT, while no changes were seen in minimum resistance (Rmin). ΔPWV showed a positive linear association to Δ24-hour MAP in both groups. Multiple linear regression analysis (adjusting for age, gender, and the baseline value of the studied parameter) did not detect independent effects of graft function on 24-hour MAP, PWV, AIx, vascular resistance, or Pexcess, whereas low post-donation GFR was related to higher AIx and Rrest. Conclusions RT reduced BP and AIx without affecting PWV, whereas LKD resulted in increased PWV and Rrest, despite unchanged BP.

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Prediction of Cardiovascular Events After Renal Transplantation

Cited by 12 publications

References 37 publications

Assessment of Arterial Stiffness, Volume, and Nutritional Status in Stable Renal Transplant Recipients

Assessment of Arterial Stiffness, Volume, and Nutritional Status in Stable Renal Transplant Recipients

Aerobic or Resistance Training and Pulse Wave Velocity in Kidney Transplant Recipients: A 12-Week Pilot Randomized Controlled Trial (the Exercise in Renal Transplant [ExeRT] Trial)

Influence of Renal Transplantation and Living Kidney Donation on Large Artery Stiffness and Peripheral Vascular Resistance

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