New
Service for TodaysSeniorsNetwork.com
readers...roll mouse over, click on
highlighted links in stories to review items
from Amazon
Now, keep up to date
with daily feeds of newly posted stories
about America's Seniors...click on the box
to the left
Kidney donor
age linked to Aortic stiffening
Newswise —
Transplantation of kidneys from older donors
is followed by increased stiffening of the
recipient's aorta—which may help to explain
the higher rates of cardiovascular disease
and death in patients receiving kidneys from
"expanded criteria" donors, reports a study
in the April Journal of the American Society
of Nephrology.
Led by Drs. Michel
Delahousse and Michel Chaignon of Foch
Hospital in Suresnes, France, and
Jean-Philippe Haymann of Tenon Hospital in
Paris, the researchers used a technique
called carotid-femoral pulse wave velocity
to measure aortic stiffness in 74 patients
who had received kidney transplants from
deceased donors.
The aorta is the body's
large central artery; increased stiffness is
a sign of damage to the large arteries. Such
arterial damage is one of the main reasons
for the high rates of cardiovascular disease
and death in patients with end-stage renal
disease (ESRD).
When first measured,
three months after transplantation, aortic
stiffness was related exclusively to
characteristics of the transplant recipient.
The aorta was stiffer
in transplant recipients who were men,
older, and had higher blood pressure.
However, when the
measurement was repeated after 12 months,
aortic stiffness had gotten significantly
worse in patients who received kidneys from
the oldest donors (53- to 70-years old).
"We found that donor
age emerged as a strong and independent
determinant of recipient aortic stiffness
one year post-transplantation," comments Dr
Delahousse. In contrast, for patients
receiving kidneys from younger donors,
aortic stiffness decreased.
For recipients of
older-donor kidneys, pulse wave velocity was
increased by one meter per second—"A very
significant finding," adds Dr. Delahousse.
"Indeed, such an increase was previously
associated with a 39 percent increase in
overall risk of death in ESRD patients."
The results could be a significant step
toward targeted interventions after kidney
transplantation, with the goal of reducing
cardiovascular risk and mortality and
improving long-term results.
"Early identification
of patients with worsening arterial disease
following transplantation would mean that
they could benefit from drug treatments to
reduce arterial stiffness," says Dr
Delahousse.
Further studies would
be needed to determine whether this strategy
improves the overall outcomes of kidney
transplantation.
The findings also
provide an intriguing new piece of evidence
regarding the complex interrelationships
between the kidneys and cardiovascular
system.
"Our study provides the
first strong cause-and-effect evidence of
the impact of kidney characteristics upon
the mechanical properties of large
arteries," states Dr. Delahousse.
"The results suggest
that the kidney could be involved, normally
or otherwise, in the process of arterial
stiffening that is the hallmark of aging of
the large arteries."
The results do not
question the increasingly common practice of
transplantation from expanded criteria
donors (ECD).
These donors have
certain characteristics—such as older age,
high blood pressure, or slightly decreased
kidney function—that make them less than
ideal as organ donors. Dr. Delahousse
emphasizes: "In the current context of organ
shortage, ECD transplantation confers a
significant survival advantage compared to
remaining on dialysis, even if only under
certain conditions."
The researchers
acknowledge some limitations of their study,
including its small size and a potential but
"reasonably low" risk of selection bias.
The American Society of
Nephrology (ASN) is a not-for-profit
organization of 10,500 physicians and
scientists dedicated to the study of
nephrology and committed to providing a
forum for the promulgation of information
regarding the latest research and clinical
findings on kidney diseases.
ASN publishes
JASN, the Clinical Journal of the American
Society of Nephrology (CJASN), and the
Nephrology Self-Assessment Program (NephSAP).
...
...
...