Background: Chronic kidney disease is associated with an increased arterial stiffness (Ast) and left ventricular (LVM) mass. Increased ASt results in an elevated pulse wave velocity (PWV). Few data are available on the evolution of PWV and LVM following renal transplantation (RTX) in children.

Aim, subjects, Methods: Children (aged 13,4 (0,88) years /mean(SD)/) with end stage renal disease followed by successful RTX were identified. 26 patients underwent PWV measurement 2,81 (0,03) years after RTx, with repeat PWV measurement and echocardiography 3,5 (1,08) years after transplantation. The LVM index (LVMi) was calculated. PWV was measured by applanation tonometry. Age and height matched PWV normal values were used, SD score was calculated. Candidate clinical variables for an association with LVMi and PWV were assessed, including age, rutine laboratory findings, medications (serum levels and cumulative doses) and co-morbidities (hypertension, diabetes, dyslipidaemia).

Results: PWV age SDS (1,18(1,22)) and PWV height SDS (1,47 (1,21)) of RTx were increased compared to healthy pediatric population. Follow up measurement of PWV revealed increased PWV age SDS (1,18 vs 0,19) 3.5 years after RTx. Follow up measurement of PWV age SDS correlated with LVMi (r: 0,61, p:0,01). There was a bimodal correlation between LVMi and cumulative calcitriol dose before RTx.

Conclusion: Controls matched both for age and height should be used to assess PWV in RTx children with growth failure. Ast determined by PWV increased after RTx, and correlated with left ventricular hypertrophy (LVMi). Cumulative dose of calcitriol is among the major determinants of left ventricular hypertrophy after Tx.