NEW YORK (Reuters Health) - In living kidney donors, pulse wave velocity and pulse pressure, indicators of arterial stiffness, are associated with renal factors, according to a report in the February issue of Hypertension. In recipients, graft rejection is a main determinant of pulse wave velocity.

The findings are based on a study of arterial stiffness and renal function in 101 kidney donor-recipient pairs and in 263 healthy volunteers -- about half were related to the recipients and half were not.

Independent of other factors, donors and recipients had significantly elevated pulse wave velocities compared with controls, senior author Dr. Michel E. Safar, from Hotel-Dieu in Paris, and colleagues note. In healthy subjects, pulse wave velocity was exclusively related to gender, age, and blood pressure, whereas in donors and recipients, cardiovascular risk factors, smoking status, and glucose levels appeared to play a role.

By and large, renal factors were most strongly linked to pulse wave velocity in donors and recipients, including time since nephrectomy, the presence of proteinuria, and graft rejection. Plasma creatinine doubling due to chronic allograft nephropathy was linked to renal rejection and donor pulse wave velocity, regardless of age.

"Our findings strongly suggest consistent interactions between kidney function and arterial stiffness," the authors conclude.

In a related editorial, Dr. Robert D. Toto, from the University of Texas Southwestern Medical Center in Dallas, comments that "this study tells us that larger scale and long-term follow-up of donors and kidney transplant recipients is needed to identify important clinical variables that can predict outcomes and, thus, provide new insight into the diagnosis and management of kidney and cardiovascular disease."

Hypertension 2006;47:216-221

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