Erschienen in:
Kidney and Blood Pressure Research, 43 (2018) 3, Seite 793-806
Sprache:
Englisch
DOI:
10.1159/000489915
ISSN:
1420-4096;
1423-0143
Entstehung:
Anmerkungen:
Beschreibung:
<b><i>Background/Aims:</i></b> Whether the immunosuppressive regimen is associated with micro- and macro-vascular status in pediatric kidney transplant recipients (KTx) is unknown. <b><i>Methods:</i></b> We performed a cross-sectional, case-control study in 44 pediatric KTx patients on either everolimus (EVR) plus calcineurin inhibitor or standard treatment, i.e. mycophenolate mofetil plus calcineurin inhibitor. Measurement of carotid intima-media thickness (cIMT) via ultrasound, central pulse wave velocity (PWV) by a cuff-based oscillometric technique, and skin microvascular blood flow during local heating via laser-Doppler-fluximetry (LDF) served as marker of subclinical vascular disease. Serum concentrations of angiopoietin-1 and -2, fibroblast-growth factor 23 (FGF23) and soluble klotho were measured. <b><i>Results:</i></b> EVR-treated patients exhibited a similar degree of hypertension, increased cIMT, elevated pro-inflammatory angiopoietin-2, and diminished endothelial survival factor angiopoietin-1 compared to healthy children but presented with a twofold more reduced skin micro-vascular function compared to standard treatment (each p&#x3c; 0.001). By contrast, PWV and soluble klotho levels were normal in both groups. <b><i>Conclusion:</i></b> Endothelial dysfunction seems more frequent in KTx patients on EVR-based immunosuppressive regimen compared to standard immunosuppression.