Cardiovascular Risk Factors and Markers of Atherosclerosis in Stable Kidney Transplant Recipients

Abstract Background There is limited evidence regarding the risk factors influencing vascular injury in kidney transplant recipients, except for accelerated vasculopathy and endothelial dysfunction in the pre-transplantation period of end-stage renal failure. Therefore, we performed a cross-sectiona...

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Bibliographic Details
Published in:Transplantation proceedings 2016-06, Vol.48 (5), p.1543-1550
Main Authors: Kolonko, A, Chudek, J, Szotowska, M, Kuczera, P, Wiecek, A
Format: Article
Language:English
Subjects:
Adult
Aged
Atherosclerosis - metabolism
Atherosclerosis - pathology
Biomarkers - metabolism
Cardiovascular Diseases - etiology
Cardiovascular Diseases - metabolism
Carotid Intima-Media Thickness
Cross-Sectional Studies
Female
Humans
Kidney Transplantation
Male
Middle Aged
Pulse Wave Analysis
Risk Factors
Surgery
Transplant Recipients
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Summary:Abstract Background There is limited evidence regarding the risk factors influencing vascular injury in kidney transplant recipients, except for accelerated vasculopathy and endothelial dysfunction in the pre-transplantation period of end-stage renal failure. Therefore, we performed a cross-sectional study to evaluate the role of traditional and novel or potential nontraditional risk factors in vascular and endothelial dysfunction in a cohort of stable kidney transplant recipients. Methods One hundred forty-two kidney transplant recipients at 8.4 ± 1.8 years after transplantation were enrolled into the study. Different markers of vascular injury, such as carotid intima-media thickness (IMT), pulse wave velocity (PWV), and peripheral arterial tonometry (PAT), were assessed. Inflammatory markers, oxidative stress and endothelial function surrogate markers, adhesion molecules, and parathormone and osteoprotegerin levels were measured. Results Among traditional risk factors, only age, pre-transplantation diabetes, left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) were related to increased IMT and PWV, whereas PAT values were significantly decreased only in diabetics and patients with CVD and were similar in patients with and without LVH. In multivariate regression analysis, IMT was explained by age, previous CVD episodes, and higher high-sensitivity C-reactive protein levels, and PWV by age and pre-transplantation diabetes. The regression analysis failed to find any significant explanatory variables for PAT. Conclusions 1. In stable kidney transplant recipients, age, pre-transplantation diabetes, previous cardiovascular episode, and systemic microinflammation were predictors of vascular injury. 2. PAT is poorly associated with traditional CV risk factors and does not correspond with levels of biochemical markers of endothelial dysfunction in those patients.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2015.12.134