Kidney Transplant Research - Risks, Prognosis, Procedure, Surgery, Organ Donation

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Endothelial dysfunction and fetuin A levels before and after kidney transplantation.

Caglar K, Yilmaz MI, Saglam M, Cakir E, Kilic S, Eyileten T, Sonmez A, Oguz Y, Oner K, Ors F, Vural A, Yenicesu M

Department of Nephrology, Gülhane School of Medicine, Ankara, Turkey. kaysercaglar@yahoo.com

BACKGROUND: Endothelial dysfunction (ED) has a major role in the cardiovascular outcome of patients with chronic kidney disease (CKD). The aim of this study was to investigate the relation between fetuin A levels and ED in kidney transplant recipients. METHODS: Forty-two living donor kidney transplant recipients, 21 (11 male) on cyclosporine A and 21 (10 male) on tacrolimus-based regimes, were studied. Forty-two (21 male) healthy subjects were enrolled as controls. Fetuin A, highly sensitive C-reactive protein (hsCRP) levels, brachial artery endothelium-dependent vasodilatation (FMD), nitroglycerine mediated dilatation (NMD), and carotid intima-media thickness (CIMT) were measured before transplantation and on the 30th and 90th days posttransplant. RESULTS: Pretransplantation serum fetuin A concentrations and FMD values of patients were significantly lower than those of the controls (P<0.001 for both). These were significantly increased in the 30th and 90th days posttransplantation There was a significant positive correlation between Fetuin A and FMD levels both before and after kidney transplantation (r=0.534, r=0.576; respectively, P<0.001 for both). Carotid intima-media thickness and hsCRP levels decreased after transplantation (P<0.001 for all). According to the regression analysis, fetuin A, intact parathyroid hormone, and hsCRP levels were the independent determinants of FMD. CONCLUSION: The results of the present study suggest that low serum fetuin A levels in CKD may contribute to impaired endothelial functions in CKD. Future studies should clarify the role of fetuin A levels in cardiovascular outcomes of CKD.

Published 23 February 2007 in Transplantation, 83(4): 392-7.
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Kidney Transplant Research Today Archive:

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