Microvascular disease after renal transplantation

Ooi, Qi Lun, Tow, Foong Kien Newk-Fon Hey, Deva, Raj, Kawasaki, Ryo, Wong, Tien-Y, Colville, Deb, Ierino, Francesco, Hutchinson, Anastasia F and Savige, Judy 2015, Microvascular disease after renal transplantation, Kidney blood pressure research, vol. 40, pp. 575-583, doi: 10.1159/000368533.

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Title Microvascular disease after renal transplantation
Author(s) Ooi, Qi Lun
Tow, Foong Kien Newk-Fon Hey
Deva, Raj
Kawasaki, Ryo
Wong, Tien-Y
Colville, Deb
Ierino, Francesco
Hutchinson, Anastasia FORCID iD for Hutchinson, Anastasia F orcid.org/0000-0002-0014-689X
Savige, Judy
Journal name Kidney blood pressure research
Volume number 40
Start page 575
End page 583
Total pages 9
Publisher Karger
Place of publication Basel, Switzerland
Publication date 2015-12
Keyword(s) Renal transplantation
Retinal arterioles
Summary Background/Aims: Individuals who reach end-stage kidney disease (CKD5) have a high risk of vascular events that persists even after renal transplantation. This study compared the prevalence and severity of microvascular disease in transplant recipients and patients with CKD5. Methods: Individuals with a renal transplant or CKD5 were recruited consecutively from renal clinics, and underwent bilateral retinal photography (Canon CR5-45, Canon). Their retinal images were deidentified and reviewed for hypertensive/microvascular signs by an ophthalmologist and a trained grader (Wong and Mitchell classification), and for vessel caliber at a grading centre using a computer-assisted method and Knudtson’s modification of the Parr-Hubbard formula. Results: Ninety-two transplant recipients (median duration 6.4 years, range 0.8 to 28.8) and 70 subjects with CKD5 were studied. Transplant recipients were younger (p<0.001), with a higher eGFR (p< 0.001), but were just as likely to have a moderate-severe hypertensive/microvascular retinopathy (46/92, 50%) as subjects with CKD5 (38/70, 54%; OR 0.84, CI 0.45 to 1.57, p=0.64), and had similar mean arteriole and venular calibres (135.1 ± 7.5 μm and 137.9 ± 14.9 μm, p=0.12; and 199.1 ± 17.8 μm and 202.4 ± 27.8 μm, p=0.36, respectively). Arteriole and venular caliber were not different in nine patients examined before and after transplantation (p=0.62 and p=0.11, respectively). Conclusions: Hypertensive/microvascular disease occurred just as often and was generally as severe in transplant recipients and subjects with CKD5. Microvascular disease potentially contributes to increased cardiac events post- transplantation.
Language eng
DOI 10.1159/000368533
Field of Research 1103 Clinical Sciences
111099 Nursing not elsewhere classified
Socio Economic Objective 920210 Nursing
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Karger
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080181

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