Hotta K, Harada H, Sasaki H, Iwami D, Fukuzawa N, Morita K, Seki T, Togashi M, Nonomura K
Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Transplant Proc. 2012 Apr;44(3):684-6. doi: 10.1016/j.transproceed.2011.11.016.
Successful kidney transplantation (KTx) can ameliorate bodily damage caused by end-stage renal disease (ESRD). Arterial stiffness (AS) is one of the critical factors that shorten the survival of patients due to cardiovascular events. KTx may reduce AS as well; however, this has not been investigated well. We therefore conducted a retrospective study using noninvasive pulse wave velocity (PWV), which is a useful index of aortic damage.
Fifty-eight consecutive kidney recipients (34 men, 24 women) were enrolled in this study. Mean age at transplantation was 40.5 ± 12.3 years and the dialysis period was 73.1 ± 95.8 months. The brachial-ankle PWV was measured preoperatively and 6 months postoperatively. First, we investigated the relationship between the PWV and the other parameters related to AS. Second, we studied the pre- to posttransplant change in PWV to evaluate the amelioration of AS after successful KTx.
PWV showed significant positive correlations with age, systolic blood pressure (BP), diastolic BP, and abdominal aortic calcification index. After successful KTx, PWV significantly decreased (P < .01). In addition, systolic and diastolic BP significantly decreased (P < .01 and P < .05, respectively).
Successful KTx ameliorates AS in ESRD patients. This might explain the improved cardiovascular prognosis of ESRD patients who undergo KTx.
成功的肾移植（KTx）可改善终末期肾病（ESRD）所致的身体损害。动脉僵硬度（AS）是因心血管事件缩短患者生存期的关键因素之一。KTx也可能降低AS；然而，这方面尚未得到充分研究。因此，我们使用无创脉搏波速度（PWV）进行了一项回顾性研究，PWV是主动脉损害的一个有用指标。
本研究纳入了58例连续的肾移植受者（34例男性，24例女性）。移植时的平均年龄为40.5±12.3岁，透析时间为73.1±95.8个月。术前及术后6个月测量肱踝PWV。首先，我们研究了PWV与其他AS相关参数之间的关系。其次，我们研究了移植前后PWV的变化，以评估成功的KTx后AS的改善情况。
PWV与年龄、收缩压（BP）、舒张压及腹主动脉钙化指数呈显著正相关。成功的KTx后，PWV显著降低（P<.01）。此外，收缩压和舒张压也显著降低（分别为P<.01和P<.05）。
成功的KTx可改善ESRD患者的AS。这可能解释了接受KTx的ESRD患者心血管预后改善的原因。
