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Canlıdan Renal Transplantasyon Yapılan Olgularda Arteriyel Sertliği Etkileyen Faktörler

Affecting Factors of Arterial Stiffness in Living Related Kidney Transplant Recipients

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2011

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Arterial stiffness might be affected by several factors including recipient as well as donors. In this study, we aimed to evaluate arterial stiffness in living related kidney transplant recipients before and after transplantation. We enrolled 47 living related kidney recipients and pulse wave velocity (PWV) was determined before and after transplantation. Donor renal arterial biopsy, recipient iliac artery samples were taken during the operation and PWV was also determined for the donors. Forty-seven patients completed the study. Post-transplantation follow-up duration was 18.5±5.7 months. Before transplantation, the mean PWV 8.1±1.4 m/sec and it was 7.5±2.0 m/sec after the transplantation (p=0.014). The patients were divided into two groups as with (30 patients) and without (17 patients) a PWV decrease. Recipient age, gender, CRP, PTH, lipids, and blood pressures were not significantly different between the groups. The recipient body mass index was higher in patients with a PWV decrease. Donor-related factors were not different between the groups. We found that blood pressure and LDL cholesterol levels in recipients were associated with a decrease in PWV after the transplantation. In conclusion, donor-related factors do not seem to have an impact on arterial stiffness in recipients. Pretransplant BMI and posttransplant blood pressure and LDL cholesterol levels were associated with a decrease in PWV.
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Abstract (Original Language): 
Renal transplant (RTx) sonrasında arteriyel sertlikte gözlenen değişiklikler alıcı özellikleri olduğu kadar verici özellikleri ile de ilişkili olabilir. Bu çalışmada canlıdan RTx yapılan hastalarda arteriyel sertlikte gözlenen değişikler ve ilişkili olabilecek faktörlerin analizi amaçlanmıştır. Çalışmaya merkezimizde canlıdan böbrek nakli yapılan hastalar alındı. Hastalarda nakil öncesi ve sonrası arteriyel sertlik ölçümleri nabız dalga hızı (NDH) ile yapıldı. Alıcıların ve vericilerin demografik özellikleri yanı sıra arteriyel sertlik, alıcı iliak arter örneği ve verici renal arter örneklerinden histopatolojik değerlendirme yapıldı. Toplam 47 hasta analize alındı. Hastaların post-transplant izlem süreleri ortalama 18,5±5,7 ay idi. Tüm olguların RTx öncesinde ortalama NDH 8,1±1,4 m/sn iken, sonrasında 7,5±2,0 m/sn olarak ölçümlendi (p=0,014). Hastalar NDH azalan ve (30 hasta) ve azalmayan olarak (17 hasta) 2 gruba ayrıldığında alıcı yaş, cinsiyet, CRP, PTH, lipid düzeyleri, ve kan basınçları arasında anlamlı farklılık saptanmadı. NDH düşmeyen olgularda alıcı vücut kitle indeksi daha yüksekti. Verici yaş, cinsiyet ve NDH anlamlı farklılık göstermiyordu. Nakil sonrasında ise kan basınçları ve LDL düzeyleri NDH düşen grupta anlamlı yüksekti. Sonuçta RTx sonrasında NDH’da düşme gözlenirken bu tüm olguları kapsamamaktadır. RTx öncesi BKİ, RTx sonrası kan basınçları ve LDL kolesterol düzeyi NDH düşüşü için anlamlı bulunurken verici kaynaklı faktörlerin bu olayda belirgin bir rol oynadığı mevcut çalışma ile desteklenmemiştir.
FULL TEXT (PDF): 
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  • 2
178-186
  • Turkish

REFERENCES

References: 

1. Foley RN, Parfrey PS, Sarnak MJ: Clinical epidemiology of
cardiovascular disease in chronic renal disease. Am J Kidney Dis
1998; 32: 112-119
2. Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa
LY, Held PJ, Port FK: Comparison of mortality in all patients on
dialysis, patients on dialysis awaiting transplantation, and recipients
of a first cadaveric transplant. N Engl J Med 1999; 341(23): 1725-
1730
3. Meier-Kriesche HU, Schold JD, Srinivas T, Reed A, Kaplan B:
Kidney transplantation halts cardiovascular disease progression in
patients with end-stage renal disease. Am J Transplant 2004; 4(10):
1662-1668
Eşmen S E ve ark : Renal Transplantasyon Sonrası Arteriyel Sertlik
186 Turk Neph Dial Transpl 2011; 20 (2): 178-186
Türk N efroloji D iyaliz ve Transplantasyon D ergisi
Turkish Nephrology, Dialysis and Transplantation Journal
4. Ojo AO: Cardiovascular complications after renal transplantation
and their prevention. Transplantation 2006; 82(5): 603-611
5. Ducloux D, Kazory A, Chalopin JM: Predicting coronary heart
disease in renal transplant recipients: A prospective study. Kidney
Int 2004; 66(1): 441-447
6. Blacher J, Safar ME, Pannier B, Guerin AP, Marchais SJ, London
GM: Prognostic significance of arterial stiffness measurements
in end-stage renal disease patients. Curr Opin Nephrol Hypertens
2002; 11(6): 629-634
7. Covic A, Goldsmith DJ, Gusbeth-Tatomir P, Buhaescu I, Covic
M: Successful renal transplantation decreases aortic stiffness and
increases vascular reactivity in dialysis patients. Transplantation
2003; 76(11): 1573-1577
8. Zoungas S, Kerr PG, Chadban S, Muske C, Ristevski S, Atkins RC,
McNeil JJ, McGrath BP: Arterial function after successful renal
transplantation. Kidney Int 2004; 65(5): 1882-1889
9. Delahousse M, Chaignon M, Mesnard L, Boutouyrie P, Safar ME,
Lebret T, Pastural-Thaunat M, Tricot L, Kolko-Labadens A, Karras
A, Haymann JP: Aortic stiffness of kidney transplant recipients
correlates with donor age. J Am Soc Nephrol 2008; 19(4): 798-805
10. Reutzel-Selke A, Jurisch A, Denecke C, Pascher A, Martins P N,
Kessler H, Tamura A, Utku N, Pratschke J, Neuhaus P, Tullius
SG: Donor age intensifies the early immune response after
transplantation. Kidney Int 2007; 71(7): 629-636
11. Rigatto C, Parfrey P: Therapy insight: Management of cardiovascular
disease in the renal transplant recipient. Nat Clin Pract Nephrol
2006; 2(9): 514-526
12. Covic A, Gusbeth-Tatomir P, Goldsmith DJ: Arterial stiffness in
renal patients: An update. Am J Kidney Dis 2005; 45(6): 965-977
13. Keven K, Calayoglu R, Sengul S, Dincer I, Kutlay S, Erturk S, Erbay
B, Nergizoglu G: Comparative effects of renal transplantation and
maintenance dialysis on arterial stiffness and left ventricular mass
index. Clin Transplant 2008; 22(3): 360-365
14. Sengstock D, Sands RL, Gillespie B W, Zhang X, Kiser M, Eisele G,
Vaitkevicius P, Kuhlmann M, Levin NW, Hinderliter A, Rajagopalan
S, Saran R: Dominance of traditional cardiovascular risk factors over
renal function in predicting arterial stiffness in subjects with chronic
kidney disease. Nephrol Dial Transplant 2010; 25(3):853-861
15. Montanaro D, Gropuzzo M, Tulissi P, Vallone C, Boscutti G,
Mioni R, Risaliti A, Baccarani U, Adani GL, Sainz M, Lorenzin D,
Bresadola F, Mioni G: Effects of successful renal transplantation on
left ventricular mass. Transplant Proc 2005; 37(6): 2485-2487
16. Aoki A, Kojima F, Uchida K, Tanaka Y, Nitta K: Associations
between vascular calcification, arterial stiffness and bone mineral
density in chronic hemodialysis patients. Geriatr Gerontol Int 2009;
9(3): 246-252
17. Holdaas H, Fellstrom B, Jardine AG, Holme I, Nyberg G, Fauchald
P, Gronhagen-Riska C, Madsen S, Neumayer HH, Cole E, Maes B,
Ambuhl P, Olsson AG, Hartmann A, Solbu DO, Pedersen TR: Effect
of fluvastatin on cardiac outcomes in renal transplant recipients: A
multicentre, randomised, placebo-controlled trial. Lancet 2003;
361(9374): 2024-20231
18. Andres V, Castro C, Campistol JM: Potential role of proliferation
signal inhibitors on atherosclerosis in renal transplant patients.
Nephrol Dial Transplant 2006; 21: 14-17
19. Israni AK, Snyder J J, Skeans MA, Peng Y, Maclean JR, Weinhandl
ED, Kasiske BL: Predicting coronary heart disease after kidney
transplantation: Patient Outcomes in Renal Transplantation (PORT)
Study. Am J Transplant 2010; 10(2): 338-353
20. Sigrist K, Taal MW, Bungay P, McIntyre CWM: Progressive vascular
calcification over 2 years is associated with arterial stiffening and
increased mortality in patients with stages 4 and 5 chronic kidney
disease. Clin J Am Soc Nephrol 2007; 2(6): 1241-1248
21. Sumida Y, Nakayama M, Nagata M, Nakashita S, Suehiro T,
Kaizu Y, Ikeda H, Izumaru K: Carotid artery calcification and
atherosclerosis at the initiation of hemodialysis in patients with endstage
renal disease. Clin Nephrol 2010; 73(5): 360-369
22. Kneifel M, Scholze A, Burkert A, Offermann G, Rothermund L,
Zidek W, Tepel M: Impaired renal allograft function is associated
with increased arterial stiffness in renal transplant recipients. Am J
Transplant 2006; 6(7): 1624-1630
23. Bhan I, Thadhani R: Vascular calcification and ESRD: A hard target.
Clin J Am Soc Nephrol 2009; 4: 102-105
24. Shroff RC, McNair R, Figg N, Skepper JN, Schurgers L, Gupta A,
Hiorns M, Donald A E, Deanfield J, Rees L, Shanahan CM: Dialysis
accelerates medial vascular calcification in part by triggering smooth
muscle cell apoptosis. Circulation 2008; 118(17): 1748-1757
25. Schwarz U, Buzello M, Ritz E, Stein G, Raabe G, Wiest G, Mall
G, Amann K: Morphology of coronary atherosclerotic lesions in
patients with end-stage renal failure. Nephrol Dial Transplant 2000;
15(2): 218-223

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