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Microvascular disease after renal transplantation

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Version 2 2024-06-03, 21:49
Version 1 2015-12-10, 10:24
journal contribution
posted on 2024-06-03, 21:49 authored by QL Ooi, FK-FH Tow, R Deva, R Kawasaki, T-Y Wong, D Colville, F Ierino, Ana HutchinsonAna Hutchinson, J Savige
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.

History

Journal

Kidney blood pressure research

Volume

40

Pagination

575-583

Location

Basel, Switzerland

Open access

  • Yes

Language

eng

Publication classification

C Journal article, C1.1 Refereed article in a scholarly journal

Copyright notice

2015, Karger Open Access

Publisher

Karger Open Access