Noninvasive Perioperative Monitoring of Arterial Function in Patients With Kidney Transplantation

ABSTRACTDevelopment of atherosclerosis is accelerated in kidney transplant recipients. Impairedmetabolic pathways have a complex effect on the arterial wall, which can be measured bynoninvasive techniques. Few data are available on the change of stiffness parameters in thepostoperative course, so in this study we analyzed the stiffness parameters of kidneytransplant recipients during the perioperative period. Seventeen successful primary kidneytransplant patients with uneventful postoperative period (7 woman, 10 men; 46.16 12.19years) were involved in our short-term prospective longitudinal study. We analyzed thecorrelation between noninvasively assessed stiffness parameters (pulse wave velocity[PWV], augmentation index [AIx], pulse pressure [PP], systolic area index, diastolic areaindex, diastolic reflection area), ankle-brachial index (ABI), and laboratory parameters(creatinine, glomerular filtration rate, urea, haemoglobin, C-reactive protein). Stiffnessparameters were measured with a Tensiomed Arteriograph. These parameters wereassessed before the transplantation, and 24 hours, and 1 and 2 weeks after surgery understandard conditions. We found that creatinine (P ¼ .0008) and C-reactive protein(P ¼ .006) serum levels decreased, and glomerular filtration rate increased significantly(P ¼ .0005). We revealed that PWV (P ¼ .0075) and AIx (P ¼ .013) improved significantly.There was no significant change in ABI, PP, and the other monitored parameters. Alongwith the available data in the literature, our findings suggest that kidney transplantation hasa positive effect on the arterial function