Depertment of Nephrology, Hypertension and Internal Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.
Med Sci Monit. 2010 Jun;16(6):CR301-6.
Pulse wave velocity (PWV) is a marker of arterial stiffness. It was shown that PWV is related to increased cardiovascular risk in renal transplant recipients (RTR). Renal transplantation leads to decrease of arterial stiffness when compared with dialysis patients. Despite many studies, causes of increased arterial stiffness in RTR are not well defined. This study sought to investigate the association between cardiovascular risk factors, graft function, cardiovascular and immunosuppressive therapy, and carotid-femoral PWV in renal transplant recipients.
MATERIAL/METHODS: Carotid-femoral PWV were measured with Complior device in 207 (73 female and 134 male) RTR aged 45+/-12 years, and in 21 healthy volunteers as controls.
Pulse wave velocity was higher in RTR compared with controls: 9.2+/-2.1 m/s vs 8.3+/-1.5m/s (P<.05). In RTR group, significant correlations were found between PWV and age (r=0,55; P<.001), male sex (r=0.17; P<.02), body weight (r=0.23; P<.01), systolic (SBP) (r=0.36; P<.001), and diastolic blood pressure (DBP) (r=0.19; P<.01), pulse pressure (pulse pressure) (r=0.34; P<.001), mean arterial pressure (MAP) (r=0.28; P<.001), number of antihypertensive medication (r=0.17; P<.02), fasting glucose (r=0.24; P<.01), presence of diabetes (r=0.24; P<.01), eGFR (r=-0.19; P<.01), therapy with cyclosporine (r=0.29; P<.001), and therapy with tacrolimus (r=-0.22; P<.01). In stepwise multiple regression analysis, age, male sex, MAP, cyclosporine, and fasting glucose concentration were independently associated with increased PWV.
Arterial stiffness is increased in RTR. Type of immunosuppressive regimen, high blood pressure, and glucose metabolism disturbances should be considered as potential targets to reduce increased arterial stiffness in RTR.
脉搏波速度（PWV）是动脉僵硬度的标志物。已经表明，PWV 与肾移植受者（RTR）的心血管风险增加有关。与透析患者相比，肾移植会导致动脉僵硬度降低。尽管进行了许多研究，但 RTR 中动脉僵硬度增加的原因仍未得到明确界定。本研究旨在调查心血管危险因素、移植物功能、心血管和免疫抑制治疗与肾移植受者颈动脉-股动脉 PWV 之间的关系。
材料/方法：使用 Complior 设备测量了 207 名（73 名女性和 134 名男性）年龄在 45+/-12 岁的 RTR 和 21 名健康志愿者的颈动脉-股动脉 PWV。
与对照组相比，RTR 的脉搏波速度更高：9.2+/-2.1m/s 比 8.3+/-1.5m/s（P<.05）。在 RTR 组中，PWV 与年龄（r=0.55；P<.001）、男性（r=0.17；P<.02）、体重（r=0.23；P<.01）、收缩压（SBP）（r=0.36；P<.001）、舒张压（DBP）（r=0.19；P<.01）、脉压（r=0.34；P<.001）、平均动脉压（MAP）（r=0.28；P<.001）、降压药物数量（r=0.17；P<.02）、空腹血糖（r=0.24；P<.01）、糖尿病（r=0.24；P<.01）、肾小球滤过率（eGFR）（r=-0.19；P<.01）、环孢素治疗（r=0.29；P<.001）和他克莫司治疗（r=-0.22；P<.01）呈显著相关。逐步多元回归分析显示，年龄、男性、MAP、环孢素和空腹血糖浓度与 PWV 增加独立相关。
RTR 存在动脉僵硬度增加。免疫抑制方案类型、高血压和葡萄糖代谢紊乱应被视为降低 RTR 动脉僵硬度增加的潜在靶点。
