RT Journal Article
T1 Artery Wall Assessment Helps Predict Kidney Transplant Outcome.
A1 Hernández, Domingo
A1 Triñanes, Javier
A1 Salido, Eduardo
A1 Pitti, Sergio
A1 Rufino, Margarita
A1 González-Posada, José Manuel
A1 Torres, Armando
K1 Aterosclerosis
K1 Presión sanguínea
K1 Enfermedades cardiovasculares
K1 Moléculas de adhesión celular
K1 Estudios de cohortes
K1 Citocinas
K1 Diabetes mellitus
K1 Arterias epigástricas
K1 Ayuno
K1 Inflamación
K1 Trasplante de riñón
K1 Factores de riesgo
K1 Hábito de fumar
K1 Triglicéridos
K1 Calcificación vascular
AB BACKGROUNDKidney transplant recipients have high cardiovascular risk, and vascular inflammation may play an important role. We explored whether the inflammatory state in the vessel wall was related to carotid intima-media thickness (c-IMT) and patient survival following kidney transplantation.METHODSIn this prospective observational cohort study we measured c-IMT and expression of proinflammatory cytokines and adhesion molecules in the inferior epigastric artery in 115 kidney transplant candidates. Another c-IMT measurement was done 1-year post-transplantation in 107. By stepwise multiple regression analysis we explored factors associated with baseline c-IMT and their changes over time. Multivariate Cox regression analysis was constructed to identify risk factors for mortality.RESULTSA worse cardiovascular profile (older age, smoker, diabetic, carotid plaque, systolic blood pressure and vascular calcification) and higher VCAM-1 levels were found in patients in the highest baseline c-IMT tertile, who also had a worse survival. Factors independently related to baseline c-IMT were age (β=0.369, P<0.0001), fasting glucose (β=0.168, P=0.045), smoking (β=0.228, P=0.003) and VCAM-1 levels (β=0.244, P=0.002). Independent factors associated with c-IMT measurement 1-year post-transplantation were baseline c-IMT (β=-0.677, P<0.0001), post-transplant diabetes (β=0.225, P=0.003) and triglycerides (β=0.302, P=0.023). Vascular VCAM-1 levels were associated with increased risk of mortality in bivariate and multivariate Cox regression. Notably, nearly 50% of patients showed an increase or maintenance of high c-IMT 1 year post-transplantation and these patients experienced a higher mortality (13 versus 3.5%; P=0.021).CONCLUSIONA worse cardiovascular profile and a higher vascular VCAM-1 protein levels at time of KT are related to subclinical atheromatosis. This could lead to a higher post-transplant mortality. Pre-transplant c IMT, post-transplant diabetes and triglycerides at 1-year post-transplantation may condition a high c-IMT measurement post-transplantation, which may decrease patient survival.
PB Public Library of Science
YR 2015
FD 2015-06-12
LK http://hdl.handle.net/10668/2325
UL http://hdl.handle.net/10668/2325
LA en
NO Hernández D, Triñanes J, Salido E, Pitti S, Rufino M, González-Posada JM, et al. Artery Wall Assessment Helps Predict Kidney Transplant Outcome. PLoS ONE. 2015; 10(6):e0129083
NO Journal Article; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 9, 2025