Impaired Microvascular Reactivity in Patients with Chronic Kidney Disease Submitted to Kidney Transplantation: A Prospective Observational Study.

IF 2.3 4区医学 Q2 PERIPHERAL VASCULAR DISEASE Kidney & blood pressure research Pub Date : 2024-01-01 Epub Date: 2024-07-22 DOI:10.1159/000540047

Paulo Sergio Borges, Flavia Augusta Orange, Isabelle Albuquerque Pontes, Geraldine F Clough, João Guilherme Bezerra Alves

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Abstract

Introduction: The effect of kidney transplantation on endothelial dysfunction and autonomic dysfunction in uremia remains controversial, and few studies have evaluated this question. Endothelial dysfunction and autonomic dysfunction, both, be assessed noninvasively using laser Doppler flowmetry (LDF). This study evaluated cutaneous microvascular blood flow and reactivity using LDF in patients undergoing kidney transplantation.

Methods: This prospective longitudinal cohort study involved 40 patients with chronic kidney disease (CKD) undergoing kidney transplantation, compared with 40 patients without kidney disease. Using LDF, post-occlusive reactive hyperemia (PORH) (resting flow [RF], peak flow, ratio between peak, and RF, hyperemic area, PORH index), and sympathetic constrictor response to inspiratory breath-hold (mean minimum inspiratory values) were evaluated.

Results: RF and sympathetic constrictor response to inspiratory breath-hold (mean minimum inspiratory values), were lower in the CKD group at 1 week and at 3 months after transplantation (p < 0.005). Mean minimum inspiratory values increase in the CKD group, 3 months after transplantation.

Conclusion: Compared with controls with no CKD, in CKD patients undergoing kidney transplantation, microcirculation by LDF shows improvement after 3 months.

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接受肾移植的慢性肾病患者微血管反应受损：一项前瞻性观察研究。

导言：肾移植对尿毒症患者内皮功能障碍和自主神经功能障碍的影响仍存在争议，很少有研究对这一问题进行评估。内皮功能障碍和自主神经功能障碍均可通过激光多普勒血流测量仪（LDF）进行无创评估。本研究使用激光多普勒血流测量仪评估了肾移植患者的皮肤微血管血流和反应性：这项前瞻性纵向队列研究涉及 40 名接受肾移植的慢性肾脏病 (CKD) 患者，与 40 名无肾脏病的患者进行对比。使用激光多普勒血流测量仪评估了闭塞后反应性充血（PORH）[静息血流、峰值血流、峰值血流与静息血流之比、充血面积、PORH 指数]和吸气屏气时交感神经收缩反应[平均最小吸气值]：移植后一周和三个月时，CKD 组的静息血流（RF）和吸气屏气时交感神经收缩反应（平均最小吸气值）较低（p<0.005）。CDK组的平均最小吸气值在移植后三个月有所增加：结论：与未患 CKD 的对照组相比，接受肾移植的 CKD 患者的微循环在三个月后通过激光多普勒血流测量得到改善。

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来源期刊

Kidney & blood pressure research 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.