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Feng S, Wang H, Yang J, Hu X, Wang W, Liu H, Li H, Zhang X. Kidney transplantation improves arterial stiffness in patients with end-stage renal disease. Int Urol Nephrol 2020; 52:877-884. [PMID: 31925642 DOI: 10.1007/s11255-020-02376-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/03/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of mortality among the patients with end-stage renal disease (ESRD). Arterial stiffness is a well-accepted predictor of cardiovascular mortality in general population and ESRD patients. The aim of this study was to compare the change of arterial stiffness in kidney transplant recipients (KTRs) and ESRD patients, and further investigate the impact of kidney transplantation (KT) on arterial stiffness. METHODS A total of 138 maintenance hemodialysis patients, 198 KTRs and 75 healthy volunteers were enrolled in this study. The carotid-femoral pulse wave velocity (CF-PWV) and carotid-radial PWV (CR-PWV) were determined, and the correlations of PWV with biochemical parameters were analyzed. RESULTS CF-PWV was highest in the maintenance hemodialysis patients, but similar between KTRs and healthy volunteers. Bivariate correlation analysis among KTRs demonstrated that CF-PWV was positively correlated with high level of peripheral diastolic blood pressure, pulse pressure, mean artery pressure, BUN and HDL, but negatively correlated with albumin. Univariate polytomous logistic regression analysis showed that age, BMI, systolic blood pressure, pulse pressure, length of KT and BUN were associated with the increase of CF-PWV value. CONCLUSIONS Aortic stiffness could be improved after KT. Meanwhile, age, BMI, systolic blood pressure, pulse pressure, length of KT and BUN were independent predictors of the increase of CF-PWV in KTRs.
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Affiliation(s)
- Sujuan Feng
- Institute of Uro-Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, #8 Gong Ti Nan Lu, Beijing Chao yang District, Beijing, 100020, China
| | - Haozhou Wang
- Institute of Uro-Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, #8 Gong Ti Nan Lu, Beijing Chao yang District, Beijing, 100020, China
| | - Jing Yang
- Institute of Uro-Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, #8 Gong Ti Nan Lu, Beijing Chao yang District, Beijing, 100020, China
| | - Xiaopeng Hu
- Institute of Uro-Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, #8 Gong Ti Nan Lu, Beijing Chao yang District, Beijing, 100020, China
| | - Wei Wang
- Institute of Uro-Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, #8 Gong Ti Nan Lu, Beijing Chao yang District, Beijing, 100020, China
| | - Hang Liu
- Institute of Uro-Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, #8 Gong Ti Nan Lu, Beijing Chao yang District, Beijing, 100020, China
| | - Han Li
- Institute of Uro-Nephrology, Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, #8 Gong Ti Nan Lu, Beijing Chao yang District, Beijing, 100020, China.
| | - Xiaodong Zhang
- Institute of Uro-Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, #8 Gong Ti Nan Lu, Beijing Chao yang District, Beijing, 100020, China.
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Monfared A, Azimi SZ, Kazemnezhad E. The association between atorvastatin administration and plasma total homocysteine levels in renal transplant recipients. J Nephropathol 2016; 5:98-104. [PMID: 27540537 PMCID: PMC4961823 DOI: 10.15171/jnp.2016.18] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 03/19/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Statins improve prognosis in patients with coronary heart diseases by decreasing the incidence of vascular events. Excess prevalence of hyperhomocysteinemia, an independent risk factor of cardiovascular diseases, has been observed in stable renal transplant recipients (RTRs). OBJECTIVES The objective of our study was to evaluate the association between atorvastatin administration and plasma total homocysteine (tHcy) levels in RTRs. PATIENTS AND METHODS We performed a retrospective cross-sectional study in 148 cyclosporine A (CsA) treated stable RTRs. We compared tHcy level and other demographic and clinical variables in RTRs with and without atorvastatin. RESULTS 58.1% of the 148 RTRs were treated with atorvastatin (20-40 mg/day). Mean tHcy levels were lower in patients treated with atorvastatin compared to nonusers (14.80 ± 5.13 µmol/l versus 16.95 ± 7.87 µmol/l, P = 0.04). The comparison of 85 patients treated with atorvastatin and 61 non-users revealed that those subjects with atorvastatin were older, with higher estimated creatinine clearance and elevated body mass index (BMI). They were more likely to have higher systolic blood pressure and CsA trough level (C0). The association between lower tHcy levels and atorvastatin use was confirmed in the multivariate regression model (P = 0.004). However tHcy levels were independently and negatively associated with serum folate (P = 0.0001) and vitamin B12 levels (P = 0.001) and positively with serum BUN (P = 0.001) and diastolic blood pressure (P = 0.024) as well. CONCLUSIONS These data support the association between lower tHcy levels and atorvastatin administration in RTRs. Further clinical trials are recommended to clarify homocysteine lowering effect of atorvastatin.
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Affiliation(s)
- Ali Monfared
- Urology Research Center, Guilan University of Medical Sciences, Guilan, Iran
| | | | - Ehsan Kazemnezhad
- Urology Research Center, Guilan University of Medical Sciences, Guilan, Iran
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Kayadibi H, Sertoglu E, Uyanik M. Important issues in studies dealing with total homocysteine. Transplantation 2014; 98:e89. [PMID: 25436924 DOI: 10.1097/tp.0000000000000492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Huseyin Kayadibi
- 1 Adana Military Hospital Biochemistry Laboratory Adana, Turkey 2 Ankara Mevki Military Hospital, Anittepe Dispensary, Biochemistry Laboratory, Ankara, Turkey. 3 Corlu Military Hospital, Department of Medical Biochemistry, Tekirdag, Turkey
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