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Influence of renal transplantation and living kidney donation on large artery stiffness and peripheral vascular resistance

Buus, NH; Carlsen, RK; Hughes, AD; Skov, K; (2020) Influence of renal transplantation and living kidney donation on large artery stiffness and peripheral vascular resistance. American Journal of Hypertension , 33 (3) pp. 234-242. 10.1093/ajh/hpz175. Green open access

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Abstract

BACKGROUND: Vascular status following renal transplantation (RT) may improve while living kidney donation (LKD) is possibly associated with an increased cardiovascular risk. METHODS: We prospectively assessed glomerular filtration rate (mGFR, 51Chrome EDTA clearance) and intermediate vascular risk factors in terms of blood pressure (BP), pulse wave velocity (PWV), central augmentation index (AIx), excess pressure (Pexcess) and forearm vascular resistance in donors (n=58, 45±13 years) and recipients (n=51, 50±12 years) before and one year following LKD or RT. RESULTS: After kidney donation mGFR decreased by 33% to 65±11 ml/min/1.73m2 while recipients obtained a mGFR of 55±9 ml/min/1.73m2. Ambulatory 24-hour mean BP (MAP) remained unchanged in donors but decreased by 5 mmHg in recipients (P<0.05). Carotid-femoral PWV increased by 0.3 m/s in donors (P<0.05) but remained unchanged in recipients. AIx was unaltered after LKD but decreased following RT (P<0.01) while Pexcess did not change in either group. Resting forearm resistance (Rrest), measured by venous occlusion plethysmography, increased after LKD (P<0.05) but was unaffected by RT, while no changes were seen in minimum resistance (Rmin). ΔPWV showed a positive linear association to Δ24-hour MAP in both groups. Multiple linear regression analysis (adjusting for age, gender and the baseline value of the studied parameter) did not detect independent effects of graft function on 24-hour MAP, PWV, AIx, vascular resistance or Pexcess, whereas low post-donation GFR was related to higher AIx and Rrest. CONCLUSIONS: RT reduced BP and AIx without affecting PWV whereas LKD resulted in increased PVW and Rrest, despite unchanged BP.

Type: Article
Title: Influence of renal transplantation and living kidney donation on large artery stiffness and peripheral vascular resistance
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/ajh/hpz175
Publisher version: https://doi.org/10.1093/ajh/hpz175
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Blood pressure, Living kidney donation, Pulse wave velocity, Renal recipients, Renal transplantation, Vascular resistance
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10085634
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