Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Background: Chronic kidney disease (CKD) imparts enormous cardiovascular (CV) risk that is only partially improved by renal transplantation. We sought to understand the determinants of pulse wave velocity (PWV), a surrogate for vascular stiffness and a biomarker associated with CV risk, in pediatric renal transplant recipients with excellent graft function versus healthy children.
Methods: This prospective cohort (n=42) of 16 pediatric renal transplant recipients (Txp) and 26 healthy children without CKD (Control) underwent carotid-femoral PWV and pulse wave analysis using applanation tonometry. Circulating biomarkers associated with CV risk were measured at the time of PWV in transplant recipients. PWV was transformed to a z-score (PWV-Z) using the LMS method to normalize PWV for gender, age and height. The primary outcome was vascular stiffness, defined a priori as a PWV-Z > 1. Secondary outcomes included raw PWV, peripheral blood pressure (BP), central BP, body mass index (BMI), estimated GFR (Schwartz eGFR), transplant vintage, plasma fibroblast growth factor-23 (FGF23) and plasma phosphorus.
Results: Txp had a mean age of 15 ± 3.1 years, mean transplant vintage of 5.3 ± 2.9 years, mean BMI of 23.5 ± 7.8 kg/m2, and mean eGFR of 100 ± 24 ml/min/1.73 m2, with no significant differences vs. Control. No subjects were hypertensive in either group. Txp had significantly worse PWV than Control, with mean PWV of 5.9 ± 1.2 m/s vs. 4.2 ± 0.6 m/s and mean PWV-Z of 1.22 ± 0.96 vs. 0.04 ± 0.22 (both P < 0.001). Vascular stiffness was observed in 9/16 (56%) Txp vs. 1/26 (4%) Control (P < 0.001). Those with vascular stiffness were older and had higher peripheral and central BP within the normal range. BMI, eGFR, transplant vintage, FGF23 and phosphorus were similar in those with vascular stiffness vs. those without. PWV was significantly correlated with age (r2 = 0.488), peripheral SBP and DBP (r2 = 0.410; 0.454), and central SBP and DBP (r2 = 0.476; 0.464) (all P < 0.01). PWV was not correlated with gender, BMI, eGFR, transplant vintage, FGF23, or phosphorus.
Conclusions: This cohort of pediatric kidney transplant recipients had significantly more vascular stiffness than children without CKD despite excellent graft function, normal BP and normal BMI. CKD-specific factors such as eGFR, transplant vintage, FGF23 and phosphorus were not correlated with PWV.
To cite this abstract in AMA style:Seifert M, Kulsum-Mecci N, Fuentes Ldelas, Davila-Roman V, Hruska K. Increased Vascular Stiffness in Pediatric Renal Transplant Recipients Despite Normal Kidney Function, Blood Pressure, and Body Mass Index [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/increased-vascular-stiffness-in-pediatric-renal-transplant-recipients-despite-normal-kidney-function-blood-pressure-and-body-mass-index/. Accessed December 1, 2023.
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