[Background: Cardiovascular (CV) diseases are the leading cause of
death among renal transplant patients (TX). Ambulatory arterial stiffness index
(AASI) has been suggested to individually predict the cardiovascular morbidity and
Our aim was to evaluate the relationship between traditional and nontraditional
risk factors and AASI in renal transplant children.
Patients and methods: In our cross-sectional study, 35 TX patients (15.6±4.3
years of age) were investigated with 24-h ambulatory blood pressure monitoring
and AASI was defined. Anthropometric data, metabolic parameters and body composition
values were also assessed.
Results: By univariate regression analysis, BMI, volume excess, systolic blood pressure
SD score, mean pulse pressure, diastolic diurnal index, nocturnal diastolic blood
pressure fall, and the presence of hypertension showed positive correlation with AASI
(respectively r=0.53, 0.39, 0.34, 0.33, 0.41, –0.42; p<0.05). Hypertensive patients had
higher AASI values (0.47±0.13 vs. 0.36±0.18; p=0.04), which may be due to the
longer duration of dialysis and longer time since transplantation (p<0.05). BMI SDS
and nocturnal diastolic blood pressure fall remained to be the main predictors of AASI
in the whole (R2=0.44, SE=0.14, β=0.34 and –0.30, p=0.03) and in the hypertensive
group (R2=0.48, SE=0.10, β=0.47 and –0.41, p=0.01 and 0.02).
Conclusion: Early transplantation then the early treatment of obesity and hypertension
may be essential in the prevention of target organ damage and CV mortality
in children after kidney TX.]