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

Abstract

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 1½ 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.