Abstract：
Arterial stiffness is a non-traditional risk factor of cardiovascular disease and may explain part of the excess cardiovascular risk in chronic kidney disease patients. Successful renal transplantation (RT) may restore renal function and improve several metabolic abnormalities involved in arterial stiffness. This prospective study conducted non-invasive assessments of arterial stiffness indices [the augmentation index (AI) and pulse wave velocity (PWV)] in end-stage kidney disease (ESKD) patients before RT and 3 and 6 months after living-donor RT, alongside the effects of age and calcineurin inhibitors on arterial stiffness. The study included 26 ESKD patients (22 males and 4 females; mean age, 34.07 years; median duration of dialysis, 10 months) scheduled for RT and followed up for three visits (within 1 week before transplantation, and 3 and 6 months after transplantation). Six months after successful RT, the patients had nearly normal serum creatinine and significantly improved serum phosphate and intact parathyroid hormone levels. The pretransplant AI was 21.53% ± 13.61% which reduced significantly 6 months after RT to 16.19% ± 10.74% (P <0.05). Although there was a reduction in PWV 6 months after RT from the pre-transplant PWV, it was not significant. A significant correlation between age and the augmentation index was noted 3 and 6 months after RT. Patients on tacrolimus-based immunosuppression after RT showed significant improvements in the AI compared with patients on a cyclosporine-based regimen. RT helped to improve arterial stiffness indices, resulting in reduced cardiovascular risk.
摘要：
动脉僵硬是心血管疾病的非传统危险因素，可以解释慢性肾脏病患者心血管风险过高的部分原因。成功的肾移植（RT）可以恢复肾功能并改善与动脉僵硬有关的几种代谢异常。这项前瞻性研究对终末期肾脏疾病（ESKD）患者在RT之前以及活体供体RT后3和6个月的动脉僵硬度指数[增强指数（AI）和脉搏波速度（PWV）]进行了非侵入性评估。除了年龄和钙调磷酸酶抑制剂对动脉僵硬度的影响。该研究包括26例ESKD患者（男性22例，女性4例；平均年龄，34.07年；透析持续时间中位数，10个月）安排RT并随访3次（移植前1周内，以及移植后3和6个月）。RT成功六个月后，患者的血清肌酐水平接近正常,血清磷酸盐和完整的甲状旁腺激素水平显著改善.移植前AI为21.53％±13.61％，在RT后6个月显着降低至16.19％±10.74％（P<0.05）。尽管在RT后6个月的PWV与移植前的PWV相比有所减少，这并不重要。RT后3个月和6个月，年龄与增强指数之间存在显着相关性。与基于环孢素的方案患者相比，RT后基于他克莫司的免疫抑制患者的AI显着改善。RT有助于改善动脉僵硬度指数，降低心血管风险。
