Improvement in Pulse Wave Velocity and Baroreflex Sensitivity Three- and Six-Month Postrenal Transplantation

Cardiovascular diseases are an important cause of mortality in end-stage renal disease (ESRD) and increased arterial stiffness and autonomic dysfunction have been proposed to explain part of this excess cardiovascular risk. This prospective study was designed with the aim of noninvasive assessment of the vascular function, i.e., arterial stiffness in the form of pulse wave velocity (PWV) and autonomic function in the form of baroreflex sensitivity (BRS) in ESRD patients before renal transplantation (RT) and three and six months after RT. The study was conducted in 64 patients of ESRD slated for RT in the Department of Nephrology and was being followed up during all three visits (pretransplant, three-, and six-month posttransplant). The period of patient recruitment and data collection lasted for approximately 11/2 years. Although PWV did not show a significant change, the change in PWV was negatively correlated with baseline PWV, and it was statistically significant. The BRS after RT had a significant improvement as early as three months. The correlation between change in PWV and change in BRS postrenal transplant was not seen. RT improves BRS, but it is still unknown that it is through amelioration of arterial properties or neural components or/and a relative contribution of both. We suggest that the improvement in BRS postrenal transplant is probably because of the improvement in autonomic neural functions rather than the improvement in compliance of barosensitive regions of large arteries.

Automated summary

Cardiovascular diseases are a significant cause of mortality in ESRD patients, with increased arterial stiffness and autonomic dysfunction contributing to the excess cardiovascular risk. This study aimed to assess noninvasively the vascular function in ESRD patients before and after renal transplantation, showing significant improvement in BRS at three months posttransplant. There was a negative correlation between changes in PWV and baseline PWV, but no correlation was observed between changes in PWV and BRS postrenal transplant.