Arterial stiffness in kidney transplantation: a single center case-control study comparing belatacept versus calcineurin inhibitor immunosuppressive based regimen

作者：Melilli Edoardo^*; Bestard Matamoros Oriol; Manonelles Montero Anna; Sala Bassa Neus; Mast Richard; Grinyo Boira Josep M; Cruzado Josep M

来源：Nefrologia, 2015, 35(1): 58-65.

DOI：10.3265/Nefrologia.pre2014.Sep.12615

• Belatacept
• Arterial stiffness
• Calcineurin inhibitors
• Pulse wave velocity
• Renal transplantation

Arterial stiffness is nowadays a well-accepted predictor of cardiovascular mortality in general population; as well as in kidney transplant recipient population. The femoral-carotid pulse wave velocity (cf-PWV) is the widest used method to assess the arterial stiffness. The aim of this study was to test whether CNI-free immunosuppression based on belatacept was associated with lower cf-PWV, as a surrogate marker of arterial stiffness, than CNI. This was a retrospective case-control study. We included all the cases treated with belatacept as a maintenance immunosuppression in our center (n= 20). An appropriate control group of patients (n= 20) treated with CNI was selected to achieve match for key factors associated with arterial stiffness. After a follow-up of 5 years after transplantation, the Belatacept group had a reduced prevalence of patients with a cf-PWV higher than 8.1m/s (50% in BLC vs. 25% in CNI, p= 0.08). At multivariate logistic regression analysis, the risk of high cf-PWV was correlated with age (OR 1.24; p< 0.03) and renal resistive index (OR 1.25; p< 0.05). Belatacept treatment was associated with a significant reduction in risk of cf-PWV (OR 0.008; P= 0.045). Belatacept-based maintenance immunosuppression could improve kidney transplant recipient's survival by reducing cardiovascular events related to stiffness.

• 出版日期2015