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移植肾后动脉僵硬度的演变。

Evolution of arterial stiffness after kidney transplantation.

机构信息

Department of Nephrology, Brabois Hospital, Nancy University and INSERM EA 4360, Nancy, France.

出版信息

Nephrol Dial Transplant. 2011 Oct;26(10):3386-91. doi: 10.1093/ndt/gfr058. Epub 2011 Mar 3.

Abstract

BACKGROUND

Increased arterial stiffness (AS) is a major determinant of cardiovascular complications in end-stage renal disease (ESRD) patients. Little is known about AS evolution after kidney transplantation. The aim of the study was to characterize the evolution of AS after kidney transplantation in a population of ESRD patients, in comparison to those remaining in dialysis.

METHODS

Eighty-eight patients (age between 35 and 65) were recruited from the waiting list for kidney transplantation of the University Hospital of Nancy. Two vascular evaluations were performed at a 1-year interval. During this interval, 39 patients were transplanted and 49 remained in dialysis.

RESULTS

At inclusion, median pulse-wave velocity (PWV) was similar in transplanted patients and transplantation-pending patients, respectively, 9.2 (7.9-11.9) and 9.8 (7.7-12.1) m/s. No difference between the two groups was found at the 1-year interval. Median of time after transplantation was 6.3 (3.8-10.1) months. Median of blood pressure (MBP) decreased only in the transplanted patients [99 (93-112) versus 96 (90-101) mmHg, P < 0.01] Multivariate analysis showed that PWV changes depend on changes in MBP and baseline PWV.

CONCLUSION

Although no difference in the 1-year PWV evolution was found, the low MBP value in transplanted patients allow to expect a better long-term evolution of AS and a better cardiovascular prognosis after kidney transplantation than in transplantation-pending patients.

摘要

背景

动脉僵硬度(AS)增加是终末期肾病(ESRD)患者心血管并发症的主要决定因素。关于肾移植后 AS 的演变知之甚少。本研究的目的是描述 ESRD 患者肾移植后 AS 的演变,并与仍在透析的患者进行比较。

方法

从南锡大学医院的肾移植候补名单中招募了 88 名年龄在 35 至 65 岁之间的患者。在 1 年的时间间隔内进行了两次血管评估。在此期间,39 名患者接受了移植,49 名患者仍在透析。

结果

在纳入时,移植患者和等待移植患者的脉搏波速度(PWV)中位数分别为 9.2(7.9-11.9)和 9.8(7.7-12.1)m/s,两组之间无差异。在 1 年的间隔内未发现差异。移植后的中位时间为 6.3(3.8-10.1)个月。仅在移植患者中,血压(MBP)中位数下降[99(93-112)与 96(90-101)mmHg,P < 0.01]。多变量分析表明,PWV 的变化取决于 MBP 的变化和基线 PWV。

结论

尽管在 1 年的 PWV 演变中没有发现差异,但移植患者的 MBP 值较低,这表明 AS 的长期演变和肾移植后心血管预后可能优于等待移植的患者。

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