Less arterial stiffness in kidney transplant recipients than chronic kidney disease patients matched for renal function.
cardiovascular risk
carotid-femoral pulse wave velocity (CF-PWV)
chronic kidney disease
kidney transplantation
Journal
Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
17
04
2020
accepted:
27
05
2020
entrez:
7
6
2021
pubmed:
8
6
2021
medline:
8
6
2021
Statut:
epublish
Résumé
Chronic kidney disease is associated with a high cardiovascular risk. Compared with glomerular filtration rate-matched CKD patients (CKDps), we previously reported a 2.7-fold greater risk of global mortality among kidney transplant recipients (KTRs). We then examined aortic stiffness [evaluated by carotid-femoral pulse wave velocity (CF-PWV)] and cardiovascular risk in KTRs compared with CKDps with comparable measured glomerular filtration rate (mGFR). We analysed CF-PWV in two cohorts: TransplanTest (KTRs) and NephroTest (CKDps). Propensity scores were calculated including six variables: mGFR, age, sex, mean blood pressure (MBP), body mass index (BMI) and heart rate. After propensity score matching, we included 137 KTRs and 226 CKDps. Descriptive data were completed by logistic regression for CF-PWV values higher than the median (>10.6 m/s). At 12 months post-transplant, KTRs had significantly lower CF-PWV than CKDps (10.1 versus 11.0 m/s, P = 0.008) despite no difference at 3 months post-transplant (10.5 versus 11.0 m/s, P = 0.242). A lower occurrence of high arterial stiffness was noted among KTRs compared with CKDps (38.0% versus 57.1%, P < 0.001). It was especially associated with lower mGFR, older age, higher BMI, higher MBP, diabetes and higher serum parathyroid hormone levels. After adjustment, the odds ratio for the risk of high arterial stiffness in KTRs was 0.40 (95% confidence interval 0.23-0.68, P < 0.001). Aortic stiffness was significantly less marked in KTRs 1 year post-transplant than in CKDps matched for GFR and other variables. This observation is compatible with the view that the pathogenesis of post-transplant cardiovascular disease differs, at least in part, from that of CKD
Sections du résumé
BACKGROUND
BACKGROUND
Chronic kidney disease is associated with a high cardiovascular risk. Compared with glomerular filtration rate-matched CKD patients (CKDps), we previously reported a 2.7-fold greater risk of global mortality among kidney transplant recipients (KTRs). We then examined aortic stiffness [evaluated by carotid-femoral pulse wave velocity (CF-PWV)] and cardiovascular risk in KTRs compared with CKDps with comparable measured glomerular filtration rate (mGFR).
METHODS
METHODS
We analysed CF-PWV in two cohorts: TransplanTest (KTRs) and NephroTest (CKDps). Propensity scores were calculated including six variables: mGFR, age, sex, mean blood pressure (MBP), body mass index (BMI) and heart rate. After propensity score matching, we included 137 KTRs and 226 CKDps. Descriptive data were completed by logistic regression for CF-PWV values higher than the median (>10.6 m/s).
RESULTS
RESULTS
At 12 months post-transplant, KTRs had significantly lower CF-PWV than CKDps (10.1 versus 11.0 m/s, P = 0.008) despite no difference at 3 months post-transplant (10.5 versus 11.0 m/s, P = 0.242). A lower occurrence of high arterial stiffness was noted among KTRs compared with CKDps (38.0% versus 57.1%, P < 0.001). It was especially associated with lower mGFR, older age, higher BMI, higher MBP, diabetes and higher serum parathyroid hormone levels. After adjustment, the odds ratio for the risk of high arterial stiffness in KTRs was 0.40 (95% confidence interval 0.23-0.68, P < 0.001).
CONCLUSIONS
CONCLUSIONS
Aortic stiffness was significantly less marked in KTRs 1 year post-transplant than in CKDps matched for GFR and other variables. This observation is compatible with the view that the pathogenesis of post-transplant cardiovascular disease differs, at least in part, from that of CKD
Identifiants
pubmed: 34094521
doi: 10.1093/ckj/sfaa120
pii: sfaa120
pmc: PMC8173621
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1244-1254Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.
Références
Int J Mol Sci. 2020 Mar 16;21(6):
pubmed: 32188143
Physiol Meas. 2014 Sep;35(9):1837-48
pubmed: 25154391
Kidney Int. 2002 Aug;62(2):704-14
pubmed: 12110036
Circulation. 2002 Oct 15;106(16):2085-90
pubmed: 12379578
Hypertension. 2011 Nov;58(5):833-8
pubmed: 21896935
Hypertension. 2002 Jan;39(1):10-5
pubmed: 11799071
Toxins (Basel). 2018 Jun 05;10(6):
pubmed: 29874852
PLoS One. 2018 May 3;13(5):e0195928
pubmed: 29723212
Nephrol Dial Transplant. 2016 Oct;31(10):1547-51
pubmed: 27190337
Am J Transplant. 2008 Mar;8(3):593-9
pubmed: 18294155
J Am Soc Nephrol. 2009 Jan;20(1):164-71
pubmed: 19005010
J Am Soc Nephrol. 2004 Apr;15(4):1052-60
pubmed: 15034109
Stroke. 2003 May;34(5):1203-6
pubmed: 12677025
Clin Kidney J. 2018 Jun;11(3):413-421
pubmed: 29988241
Kidney Int. 2006 Jan;69(2):350-7
pubmed: 16408126
Hypertension. 1995 Sep;26(3):485-90
pubmed: 7649586
Circ J. 2015;79(8):1773-9
pubmed: 25971408
Circ J. 2016;80(3):722-30
pubmed: 26841804
Circulation. 1999 May 11;99(18):2434-9
pubmed: 10318666
Nephrol Dial Transplant. 2002 Oct;17(10):1713-24
pubmed: 12270974
J Hypertens. 2012 Mar;30(3):445-8
pubmed: 22278144
J Am Soc Nephrol. 2005 Mar;16(3):763-73
pubmed: 15659562
Transplantation. 2015 Aug;99(8):1730-7
pubmed: 25757216
J Hypertens. 2013 Aug;31(8):1584-92
pubmed: 23822928
Circ J. 2014;78(10):2477-82
pubmed: 25109428
Hypertension. 1998 Sep;32(3):570-4
pubmed: 9740628
Nephrol Dial Transplant. 2021 Jan 1;36(1):176-184
pubmed: 32162656
Nephrol Dial Transplant. 1997 Aug;12(8):1672-9
pubmed: 9269647
Eur J Med Res. 2010 Oct 25;15(10):452-5
pubmed: 21156404
Am J Hypertens. 2016 Jan;29(1):5-13
pubmed: 26156872
J Am Heart Assoc. 2017 Sep 9;6(9):
pubmed: 28889098
Kidney Int Suppl. 2003 Jun;(85):S119-21
pubmed: 12753281
Int J Hypertens. 2019 Feb 17;2019:9189362
pubmed: 30906591
J Am Soc Nephrol. 1998 Nov;9(11):2135-41
pubmed: 9808102
BMC Med Res Methodol. 2017 Apr 28;17(1):78
pubmed: 28454568
Circ J. 2015;79(10):2088-97
pubmed: 26346172
JAMA. 1993 Sep 15;270(11):1339-43
pubmed: 8360969
Am J Kidney Dis. 1994 Jul;24(1):59-64
pubmed: 8023825
Eur Heart J. 2018 Sep 1;39(33):3021-3104
pubmed: 30165516
PLoS One. 2013 Sep 10;8(9):e74996
pubmed: 24040373
Clin J Am Soc Nephrol. 2009 Oct;4(10):1551-8
pubmed: 19696217
J Am Soc Nephrol. 2008 Apr;19(4):798-805
pubmed: 18235095
JAMA. 2001 May 16;285(19):2486-97
pubmed: 11368702
Hypertension. 2001 May;37(5):1236-41
pubmed: 11358934
Curr Opin Nephrol Hypertens. 2008 Nov;17(6):635-41
pubmed: 19031658
J Am Soc Nephrol. 1999 Jan;10(1):167-81
pubmed: 9890324
Semin Nephrol. 2014 Mar;34(2):164-79
pubmed: 24780471
Kidney Int. 2006 Jul;70(2):345-50
pubmed: 16788691
J Hypertens. 2010 Jan;28(1):163-9
pubmed: 19927012