Improved Arterial Stiffness Indices 3 and 6 Months after Living-donor Renal Transplantation

Abstract

Arterial stiffness is a non-traditional risk factor of cardiovascular disease and may explain part of the excess cardiovascular risk in chronic kidney disease patients. Successful renal transplantation (RT) may restore renal function and improve several metabolic abnormalities involved in arterial stiffness. This prospective study conducted non-invasive assessments of arterial stiffness indices [the augmentation index (AI) and pulse wave velocity (PWV)] in end-stage kidney disease (ESKD) patients before RT and 3 and 6 months after living-donor RT, alongside the effects of age and calcineurin inhibitors on arterial stiffness. The study included 26 ESKD patients (22 males and 4 females; mean age, 34.07 years; median duration of dialysis, 10 months) scheduled for RT and followed up for three visits (within 1 week before transplantation, and 3 and 6 months after transplantation). Six months after successful RT, the patients had nearly normal serum creatinine and significantly improved serum phosphate and intact parathyroid hormone levels. The pretransplant AI was 21.53% ± 13.61% which reduced significantly 6 months after RT to 16.19% ± 10.74% (P <0.05). Although there was a reduction in PWV 6 months after RT from the pre-transplant PWV, it was not significant. A significant correlation between age and the augmentation index was noted 3 and 6 months after RT. Patients on tacrolimus-based immunosuppression after RT showed significant improvements in the AI compared with patients on a cyclosporine-based regimen. RT helped to improve arterial stiffness indices, resulting in reduced cardiovascular risk.