Systemic vascular hemodynamics and transplanted kidney survival.


INTRODUCTION:High blood pressure and arterial stiffness contribute independently to cardiovascular mortality in uremic patients. High blood pressure is an established risk factor for chronic allograft nephropathy, recently named interstitial fibrosis/tubular atrophy (IF/TA). We sought to assess whether heart afterload determinants: arterial stiffness and vascular resistance or impedance accelerate kidney graft failure upon long-term observation. METHODS:Using a noninvasive method of blood pressure waveform analysis, (HDI/PulseWave/CR-2000), we studied 160 consecutive kidney transplant recipients, who were at least 3 months after transplantation, for systolic (SBP), diastolic, and mean blood pressure; pulse rate; systemic vascular resistance and impedance as well as large and small artery compliance. The associations of the hemodynamic parameters with relative increases in serum creatinine for every year of graft survival (ΔCreat) were assessed using multiple linear regression analysis. Relationships between systemic hemodynamics and kidney graft loss due to IF/TA were evaluated by Cox regression analysis, including serum creatinine, time after transplantation, delayed graft function, human leukocyte antigen mismatch, panel-reactive antibodies, cold ischemia time, donor age glomerular filtration rate as well as prescribed cardiovascular and immunosuppressive drugs. RESULTS:Over 6.6±0.4 years of follow-up, excluding four noncompliant patients, 11 patients died and 32 lost their kidney grafts, including 25 due to IF/TA. ΔCreat (10.3%±22.0%/y) was independently and positively associated with the initial SBP (β=0.26; P=.001) and serum creatinine values (β=0.16; P=.04). The risk of graft loss due to IF/TA was greater among patients with an increased serum creatinine (relative risk [RR]=59.5 per nlog-unit increase; P<.001) or higher SBP (RR=51.1 per nlog-unit increase; P=.04). Besides SBP, no other hemodynamic parameter was associated with graft failure. CONCLUSIONS:The rate of kidney graft function deterioration and risk of transplant loss due to IF/TA are not independently influenced by systemic arterial compliance, resistance, or impedance. SBP appears to be the key circulatory parameter independently affecting the progression of IF/TA, and should be a therapeutic target.


Transplant Proc


Wystrychowski G,Kolonko A,Chudek J,Zukowska-Szczechowska E,Wiecek A,Grzeszczak W




Has Abstract


2011-10-01 00:00:00














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    journal_title:Transplantation proceedings

    pub_type: 杂志文章


    authors: Cengiz N,Baskin E,Agras PI,Sezgin N,Saatci U

    更新日期:2005-09-01 00:00:00

  • Effect on Dosage Change and Intrapatient Variability After Conversion From Twice-Daily to Once-Daily Tacrolimus Among Thai Kidney Transplant Patients With and Without CYP3A4/5 Inhibitors.

    abstract:BACKGROUND:Converting to once-daily tacrolimus (Advagraf [Adv]) among renal transplant patients results in better drug adherence. Data regarding dosage and intrapatient variability changes after conversion among patients with CYP3A4/5 inhibitors (CYPinh) is lacking. METHOD:A retrospective chart review among all kidney...

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    authors: Larpparisuth N,Skulratanasak P,Vongwiwatana A,Premasathian N

    更新日期:2019-10-01 00:00:00

  • Identifying the degree of major histocompatibility complex matching in genetically unrelated dogs with the use of microsatellite markers.

    abstract:BACKGROUND:The dog has served as an important experimental model for biomedical research such as transplantation and developing immunosuppressive agents. Although major histocompatibility complex (MHC) in dogs is a dominant factor of graft rejection, it has not been well investigated in dogs compared with human. For th...

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    更新日期:2015-04-01 00:00:00

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    authors: Boeckle E,Boesmueller C,Wiesmayr S,Mark W,Rieger M,Tabarelli D,Graziadei I,Hoefer D,Antretter H,Stelzmueller I,Krugmann J,Zangerle R,Huemer H,Poelzl G,Margreiter R,Bonatti H

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    更新日期:2004-05-01 00:00:00

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    更新日期:2014-07-01 00:00:00

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    pub_type: 临床试验,杂志文章


    authors: Emparan C,Laukötter M,Wolters H,Dame C,Heidenreich S,Senninger N

    更新日期:2003-06-01 00:00:00

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    journal_title:Transplantation proceedings

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    authors: Sánchez-Lázaro IJ,Almenar L,Martínez-Dolz L,Portolés M,Cortés R,Rivera M,Salvador A

    更新日期:2010-10-01 00:00:00

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    authors: Małgorzewicz S,Dębska-Slizień A,Czajka B,Rutkowski B

    更新日期:2014-10-01 00:00:00

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    更新日期:2008-04-01 00:00:00

  • Blood transfusions before and on the day of transplantation: effects on cadaver graft survival.

    abstract::Pre-BTs significantly improve the survival rate for first cadaver transplants, by a mechanism that remains obscure. The maximal influence is seen with smaller numbers of pre-BTs (1-5 units), but is also observed with larger numbers of pre-BTs. The possible beneficial influence of Tx-BTs on graft survival is not proven...

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    authors: Feduska NJ,Amend WJ,Vincenti F,Duca R,Salvatierra O

    更新日期:1982-06-01 00:00:00

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    pub_type: 杂志文章


    authors: Goplani KR,Kute VB,Vanikar AV,Shah PR,Gumber MR,Patel HV,Modi PR,Trivedi HL

    更新日期:2010-12-01 00:00:00

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    abstract::In conventionally described simultaneous pancreas-kidney transplantation with portoenteric drainage, renal revascularization is derived from the left iliac vessels and pancreatic revascularization, from the right iliac artery. A newer technique utilizing the right iliac artery as a single inflow to both organs is desc...

    journal_title:Transplantation proceedings

    pub_type: 杂志文章


    authors: Nghiem DD

    更新日期:2008-06-01 00:00:00

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    abstract::Liver transplantation is known as a highly complex procedure. Several variables can affect the outcome. The present study is a retrospective multivariate analysis of the outcomes of primary liver transplant recipients from deceased donors. From November 2006 through January 2009, 155 patients received first liver tran...

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    authors: Wiederkehr JC,Igreja MR,Nogara MS,Gonçalves NL,Wiederkehr BA,Nascimento VB,Coelho IM,Locatelli FP

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    authors: Branco AW,Filho AJ,Kondo W,De George MA,Rangel M,De Carvalho RM,Noda RW

    更新日期:2005-06-01 00:00:00

  • The effects of C-reactive protein, interleukin-6, and tumor necrosis factor-alpha in rat allograft adventitial inflammation and allograft arteriosclerosis.

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    authors: Sun H,Lu X,Wu S,Sun W

    更新日期:2009-11-01 00:00:00

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    abstract:BACKGROUND AND AIMS:Because of their plasticity potential local and systemic application of cord blood stem cells may represent excellent candidates for cell-based therapeutic strategies in toxic liver injuries. It is already known that intraperitoneal administration of hematopoietic stem cells provides rapid liver hom...

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    authors: Di Campli C,Piscaglia AC,Rutella S,Bonanno G,Vecchio FM,Zocco MA,Monego G,Michetti F,Mancuso S,Pola P,Leone G,Gasbarrini G,Gasbarrini A

    更新日期:2005-07-01 00:00:00

  • Navigating Kidney Transplantation in the Early Phase of Coronavirus Disease 2019: Screening Patients With Reverse Transcriptase Polymerase Chain Reaction and Low-Radiation-Dose Chest Computed Tomography.

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    authors: Butt FK,Julian K,Kadry Z,Jain A

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    authors: Huang F,Liao N,Guan Y,Jin H,Ye J,Fan Z,Xuan L,Liu Q,Shi P

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  • Partial Cystectomy of Paraganglioma of the Urinary Bladder Before Living Kidney Transplantation: Case Report.

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    更新日期:2016-09-01 00:00:00

  • Effects of Ischemic Preconditioning and Postconditioning in a Renal Ischemia-Reperfusion Injury Model: A Comparative Experimental Study in Rats.

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    journal_title:Transplantation proceedings

    pub_type: 杂志文章


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    更新日期:2018-12-01 00:00:00

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    journal_title:Transplantation proceedings

    pub_type: 杂志文章


    authors: Badiou S,Perez V,Dupuy AM,Deswarte G,Frapier JM,Albat B,Cristol JP

    更新日期:2005-07-01 00:00:00

  • Comparison of postoperative morphine requirements in healthy living liver donors, patients with hepatocellular carcinoma undergoing partial hepatectomy, and liver transplant recipients.

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    journal_title:Transplantation proceedings

    pub_type: 杂志文章


    authors: Chen JP,Jawan B,Chen CL,Wang CH,Cheng KW,Wang CC,Concejero AM,Villagomeza E,Huang CJ

    更新日期:2010-04-01 00:00:00

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    journal_title:Transplantation proceedings

    pub_type: 杂志文章,评审


    authors: Schlichting CL,Schareck WD,Weis M

    更新日期:2006-04-01 00:00:00

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    journal_title:Transplantation proceedings

    pub_type: 杂志文章


    authors: Masztalerz M,Włodarczyk Z,Czuczejko J,Słupski M,Kedziora J

    更新日期:2006-01-01 00:00:00