COMPLICATIONS - CARDIOVASCULAR

Y. Caliskan¹, N. Alpay¹, B. Toz¹, T. Akagun¹, E. Kara¹, N. Polat², G. Guz², H. Oflaz², A. Turkmen¹, S. Bozfakioglu¹, M.S. Sever^1
1Department Of Internal Medicine, Division Of Nephrology, Istanbul University, Istanbul Faculty of Medicine, Istanbul/TURKEY, ²Department Of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul/TURKEY

Body: Introduction: Atherosclerotic cardiovascular diseases are still the major cause of death among renal transplant recipients. In this cross sectional study, we investigated the relationship between noninvasive predictors of atherosclerosis including aortic stiffness, carotid intima media thickness (IMT) and transthoracic coronary flow reserve (CFR) in renal transplantation. Methods: Sixty-five renal transplant recipients [42 male, 23 female, mean age: 39±11 (23-61) years] were included in the study. Thirty peritoneal dialysis (PD) patients (22 males, 17 females) included in the control group. We measured (1) aortic stiffness –aortic pulse wave velocity (PWV) and augmentation index (AIx) (2) carotid IMT and (3) CFR by means of color-guided Doppler echocardiography after dipyridamol infusion. Serum levels of biochemical markers including serum glucose, BUN, creatinine, electrolytes, uric acid, calcium, phosphorus, total protein, albumin, CRP and total, LDL and HDL cholesterol levels were measured. Associations among these variables were analyzed. Results: CFR was significantly associated with age (r=-0.500, p<0.001) and total protein (r=0.374, p=0.010). Carotid IMT was significantly associated with age (r=0.500, p<0.001), total protein (r=0.-345, p=0.018) and uric acid (r=0.371, p=0.010). Aortic PWV was also significantly associated with age (r=0.593, p<0.001). When the correlation analysis between the noninvasive predictors of atherosclerosis performed, CFR correlated significantly with aortic PWV (r=-0.361, p=0.018) and carotid IMT (r=−0.341, p=0.007). Carotid IMT correlated significantly with PWV (r=0.489, p=0.001). In multivariate analysis, carotid IMT (β=−0.431, p=0.014) was a significant independent predictor of CFR in renal transplant recipients. In the control PD group, CFR also correlated significantly with aortic PWV and carotid IMT. Conclusion: The association between CFR, aortic PWV and carotid IMT may suggest that CFR is a marker for the development of atherosclerotic coronary artery disease and could be a powerful noninvasive tool to assess cardiovascular risk in renal transplant recipients.

Disclosure: All authors have declared no conflicts of interest.