Arterial Stiffness Assessed by Oscillometric Method in Kidney Transplant, Predialysis, and Dialysis Patients

Transplant Proc. 2020 Oct;52(8):2337-2340. doi: 10.1016/j.transproceed.2020.01.132. Epub 2020 Apr 29.

Abstract

Introduction: Chronic kidney disease (CKD) is strongly associated with a higher risk of cardiovascular disease (CV). An important nontraditional risk factor of cardiovascular disease in renal patients is vascular stiffness, which currently can be evaluated by oscillometric measuring of pulse wave velocity (PWV) and heart rate-corrected augmentation index (AIx@75).

Aim: The aim of our study was to compare vascular stiffness between kidney transplant (KTx) recipients, patients on dialysis maintenance, and those in the predialysis period.

Materials and methods: A cross-sectional study of 140 patients (52 in CKD stage 3-4; 37 in CKD stage 5 on hemodialysis maintenance [HD]; and 51 KTx recipients) had their PWV and AIx@75 measured with Mobil-O-Graph (IEM Gmbh, Stolberg, Germany) blood and pulse pressure monitor.

Results: KTx, HD, and CKD G3-4 were comparable in term of age, sex, body mass index, and diagnoses of diabetes mellitus and hypertension. The PWV was higher in the HD group than in the KTx and CKD G3-4 (9.4 m/s vs 8.4 m/s vs 7.9 m/s respectively; P < .05 for HD vs other groups), while the difference between the KTx and CKD G3-4 was not significant. AIx@75 values were similar in the HD and KTx groups (27.1 and 25.6; P > .05) and significantly lower in CDK G3-4 (17.8; P < .05).

Conclusions: According to our results, the highest CV risk expressed by PWV (vascular stiffness) was found in hemodialysis patients. Although patients with CKD 3-4 and after KTx showed comparable large artery stiffness, transplant recipients additionally showed higher stiffness in smaller arteries as measured by heart rate-corrected AIx.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Arteries / physiopathology
  • Cardiovascular Diseases / etiology*
  • Cross-Sectional Studies
  • Female
  • Heart Rate
  • Humans
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Oscillometry
  • Postoperative Complications / etiology
  • Pulse Wave Analysis
  • Renal Dialysis / adverse effects*
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / physiopathology*
  • Renal Insufficiency, Chronic / therapy
  • Risk Factors
  • Vascular Stiffness*