Comparing aortic stiffness in kidney transplant recipients and patients with residual renal function

Background: The poor cardiovascular survival of patients with renal insufficiency is ameliorated by transplantation. Carotid-femoral pulse wave velocity (PWV), a marker for aortic stiffness is able to independently predict for total and cardiovascular mortality. PWV is elevated in renal insufficiency. Information is missing whether the PWV adapts to the level of residual renal function after kidney transplantation. Methods: In a cross-sectional setting PWV was determined in 40 renal transplant patients (RTx) and compared to the PWV of 40 age and sex matched patients with comparable residual renal function (CKD) and 40 matched hemodialysis patients (HD). Factors involved in the prediction of PWV were characterized in these patients. Pairs of patients were furthermore stratified according to duration of transplant followup, sex and median of age and median of blood pressure. Results: Both groups revealed comparable estimated GFR (RTx: 42.9±18.4 versus CKD: 48.3±29.1 ml/min/1.73m²) and protein-creatinine ratio (logPCR RTx: 2.33±0.45 and PWV (RTx: 9.67±1.91 and CKD: 9.72±3.21 m/s). Aortic stiffness did not differ between 3-12 months and >12 months of transplant function as compared to matched CKD patients. The status of renal function (RTx, CKD, HD) did not predict PWV. Discussion: Under the condition of matched age and sex, different states of renal function are not associated with modified aortic stiffness.