Importance of Arterial Stiffness and Aortic Arch Calcification Evaluation in Kidney Transplantation

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Mon, 2018/10/22 - 14:07
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Laboratorinė medicina. 2017,
t. 19,
Nr. 4,
p. 217 -
223

Background. Vascular calcification and arterial stiffness play an important role in cardiovascular risk assessment after kidney transplant. We aimed to evaluate: 1) the importance of aortic arch calcifica­tion and arterial stiffness gradient before transplant for cardiovascular risk assessment and in determining kidney graft function; 2) the change in aortic arch cal­cification and arterial stiffness gradient after 2 years after transplant.

Material and methods. A prospective cohort study was conducted. 37 recip­ients whithout previuos cardiovascular events were examined before kidney transplant and 2 years later. Applanation tonometry was used to measure carotid-femoral and carotid-radial pulse wave velocity. Arterial stiffness gradient was calculated carotid-femoral pulse wave velocity dividing by carotid-radial pulse wave velocity. Two different aortic arch calcification scales were used for interpreting anterior chest radiographs.

Results. Aortic arch calcification unchanged in 27 patients (72.29%), decreased in 6 (16.21%) and increased in 4 (10.81%) patients. Carotid-femoral (8.91±2,11 m/s vs. 8.00±1.90 m/s, p=0.113), carotid-radial pulse wave ve­locity (10.13±1.24 m/s vs. 9.5±1.80 m/s, p=0.125) and arterial stiffness gradient (0.88±0.27 vs. 0.84±0.29, p=0.605) were found to be not significantly decreasing. Patients with calcification had worse kid­ney graft function (glomerular filtration rate 61.15 vs 47.79 ml/min/1,73 m2, p<0.001) and five of them experienced cardiovascular events (X2=4.36, p=0.036).

Conclusions. Aortic arch calcification assesment might be a useful tool in predicting cardiovascular risk and kid­ney transplant function. The importance of arterial stiffness gradient remains unclear, especcially if the progression of cal­cification is absent.

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