Open AccessReduction of Arterial Stiffness After Kidney Transplantation: A Systematic Review and Meta‐Analysis
Author(s) -
Sidibé Aboubacar,
Fortier Catherine,
Desjardins MariePier,
Zomahoun Hervé Tchala Vig,
Boutin Amélie,
MacWay Fabrice,
De Serres Sacha,
Agharazii Mohsen
Publication year - 2017
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.117.007235
Subject(s) - medicine , arterial stiffness , pulse wave velocity , confidence interval , cardiology , meta analysis , pulse pressure , transplantation , blood pressure , kidney disease , kidney transplantation , surgery
Background End‐stage kidney disease is associated with increased arterial stiffness. Although correction of uremia by kidney transplantation ( KT x) could improve arterial stiffness, results from clinical studies are unclear partly due to small sample sizes. Method and Results We conducted a systematic review and meta‐analysis of before‐after design studies performed in adult KT x patients with available measures of arterial stiffness parameters (pulse wave velocity [ PWV ], central pulse pressure [PP], and augmentation index) before and at any time post‐ KT x. Mean difference of post‐ and pre‐ KT x values of different outcomes were estimated using a random effect model with 95% confidence interval. To deal with repetition of measurement within a study, only 1 period of measurement was considered per study by analysis. Twelve studies were included in meta‐analysis, where a significant decrease of overall PWV by 1.20 m/s (95% CI 0.67‐1.73, I 2 =72%), central PWV by 1.20 m/s (95% CI 0.16‐2.25, I 2 =83%), peripheral PWV by 1.17 m/s (95% CI 0.17‐2.17, I 2 =79%), and brachial‐ankle PWV by 1.21 m/s (95% CI 0.66‐1.75, I 2 =0%) was observed. Central PP (reported in 4 studies) decreased by 4.75 mm Hg (95% CI 0.78–10.28, I 2 =50%). Augmentation index (reported in 7 studies) decreased by 10.5% (95% CI 6.9‐14.1, I 2 =64%). A meta‐regression analysis showed that the timing of assessment post‐ KT x was the major source of the residual variance. Conclusions This meta‐analysis suggests a reduction of the overall arterial stiffness in patients with end‐stage kidney disease after KT x.