Purpose:

Evaluate the progression of endothelial function as a marker of cardiovascular disease following kidney transplant.

Background:

Endothelial dysfunction is associated with cardiovascular disease (CVD) in end stage renal disease. Its contribution to CVD in kidney transplant recipients remains unclear. Brachial artery dilatation in response to blood flow is a surrogate for coronary endothelial function (EF), with higher values indicating appropriate EF. We used brachial artery flow mediated dilation (FMD) to assess EF progression following kidney transplant. We hypothesized that EF would be improved following transplantation, potentially explaining one mechanism for improved survival.

Methods:

We performed a longitudinal prospective cohort study of 84 kidney transplant recipients, measuring FMD at 1 month (baseline) and 12 months post transplant. For this analysis, 23 of those patients were evaluated further at 24 months. The primary outcome was change in FMD over time.

Results:

Baseline demographic data of the cohort population is presented in table 1. The mean FMD was 6.7%(±4.5%), 6.2%(±5.7%), 6.5%(±5.0%) at baseline, 12 months, and 24 months, respectively. FMD did not significantly change with time (P=0.80 in the univariate analysis, P=0.33 after adjustment). Adjusting for age, BMI, race, pack years, CVD, diabetes and duration on dialysis, FMD at 12 months and 24 months decreased by 0.73%(P=0.2) and 1.2%(P=0.24) compared to baseline, respectively. In the 8 patients that had a cardiovascular event post-renal transplant, baseline FMD did not significantly predict risk stratification (P=0.17).

Conclusion:

Endothelial function did not significantly progress 12 months post kidney transplant. Future analysis will need to be performed as the cohort advances beyond their transplant date.

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