Increased cardiovascular (CV) risk caused by uraemic milieu decreases after kidney transplantation (Tx), however it remains 5 fold higher than in the general population. CV mortality can be characterized by non-invasive measure of arterial stiffness (Ast). (Pulse Wave Velocity (PWV), distensibility (D), and Intima media thickness (IMT)) Clinical studies on arterial wall damage in kidney transplant children are sparse.

Our aim was to evaluate the Ast parameters and the possible pathophysiological factors responsible for impaired arterial function among kidney Tx patients. PWV, D and IMT of 24 Tx children (age: 16.6±4.9 years) were measured by applanation tonometry, and carotid artery ultrasound. Laboratory values of lipid, calcium phosphate metabolism, and renal function were also assessed at the time of measurements and retrospectively one year after Tx.

PWV SDS of Tx showed a tendency of discrete elevation (0.97±0.71), IMT was above the 95th percentile (1.64±1,36). D SDS was in the normal range (−0.01±0.98). Compared to the controls PWV SDS showed positive correlation with creatinine, P, CaxP (r=0.51;r=0.4;r=0.46; p<0–05). P, CaxP values were significantly higher in Tx with IMT >95th percentile (0.13 vs. 2.61) one year after tx. (P 1.24 vs. 1.63 mmol/l; CaxP:3.19 vs 4.18 mmol²/l²).

To conclude, 4.5 years after Tx, both morphological and functional changes can occur. Disturbances of calcium phosphate metabolism can enhance the progression of athero- and arteriosclerosis, thus the impairment of arterial elastic function in children after transplantation.

Supported by: OTKA 71730, ETT 06-123/2009, TÁMOP-4.2.2-08/1/KMR-2008-0004