Renal Function Decline in Recipients and Donors of Kidney Grafts: Role of Aortic Stiffness
Autor: | Yazan Daaboul, Serge Korjian, Antoine Stephan, Jad Al Danaf, Rim Halaby, Pascale Salameh, Maya Khairallah, Jacques Blacher, Sola Aoun Bahous, Michel E. Safar |
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Rok vydání: | 2015 |
Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Urology Transplants Renal function Pulse Wave Analysis Kidney urologic and male genital diseases Young Adult Vascular Stiffness medicine Humans Prospective Studies Young adult Prospective cohort study Kidney transplantation business.industry Smoking Age Factors Follow up studies Middle Aged medicine.disease Kidney Transplantation Tissue Donors Transplantation medicine.anatomical_structure Nephrology Female Aortic stiffness business Follow-Up Studies Glomerular Filtration Rate |
Zdroj: | American Journal of Nephrology. 41:57-65 |
ISSN: | 1421-9670 0250-8095 |
Popis: | Background/Aims: Renal function decreases over time as a result of reduction in the number of functioning nephrons with age. In recipients and donors of kidney grafts, renal function decline may be linked differently to various parameters, namely arterial stiffness. Methods: We conducted a prospective cohort study including 101 recipients of kidney grafts and their donors aiming at determining the factors correlated to the renal function decline over time. Aortic stiffness was evaluated by the non-invasive measurement of aortic pulse wave velocity. The glomerular filtration rate was estimated using the Modification of Diet in Renal Disease (MDRD) equation and the annualized change was determined. Results: Decline in renal function was estimated at 1-year post-transplantation and annually thereafter (median follow-up 8 years, range 3.6-18.3), as the mean of the annualized decrease in the glomerular filtration rate. In recipients, filtration rate decreased by 4.8 ± 19.7 ml/min/1.73 m2 the first post-transplant year and at a yearly rate of 2.2 ± 3.8 ml/min/1.73 m2 thereafter. The first-year decline was related to smoking and acute rejection. Later decline was significantly associated with donor age and aortic stiffness. In living donors, renal function decline after the first year corresponded to 0.7 ml/min/1.73 m2, was significantly lower than that of recipients (p < 0.001), and was determined by donor age at nephrectomy. Conclusion: Recipients of kidney grafts show a glomerular filtration rate decline over time that is significantly associated with donor age and aortic stiffness after the first post-transplant year, while donors demonstrate a lower decline that is mostly determined by age at nephrectomy. |
Databáze: | OpenAIRE |
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