Arterial stiffness in kidney transplant recipients an overview of methodology and applications

ABSTRACT

Cardiovascular disease is still a major cause of mortality in kidney transplant patients. This is partially attributed to the nonclassic cardiovascular risk factors including arterial stiffness, an established independent predictor of mortality in several patient populations. An extensive search was performed to review the evolution process of the method for arterial stiffness assessment and sphygmology and their applications in chronic kidney disease before and after kidney transplantation. Despite a marked change in methodology from the ancient medical practice to the current modern medicine, noninvasive assessment of arterial stiffness is still based on pulse analysis. Currently, pulse wave velocity, augmentation index, and pulse wave reflection are preferred indexes for arterial stiffness. Increased arterial stiffness has been reported in diabetes mellitus, hypertension, chronic kidney disease, cardiovascular disease, and elderly, and reduction of arterial stiffness is a key element for efficacy of the treatment and mortality reduction. Noninvasive assessment of arterial stiffness is suggested as a part of clinical assessment for kidney transplant recipients and donors and facilitates defining high-risk patients for development of cardiovascular disease. A combination of techniques is recommended for this purpose: