Kivonat:
Background. Arterial stiffness (ASt) increases with age, a
process accelerated by uraemia and reversed by transplantation
(Tx). Increased ASt results in an elevated pulse wave velocity
(PWV). Methods. To compare the PWV of Tx patients (n = 25, age =
15.1/95% CI = 13.5-16.7/year) and healthy controls, three
control groups were formed: matched for age (A), for height and
weight (H/W) and for age and height (A/H), respectively. To
avoid bias from the growth deficit of Tx, firstly Z-scores of
PWV were calculated (PWV-Z). Second, the PWV/height (PWV/h)
ratio was assessed. Pre-Tx serum Ca, P, PTH and the cumulative
dose of calcitriol (cCTL) were also analysed. Finally, Tx
patients were compared to ESRD patients (n = 11). PWV was
measured by applanation tonometry. Results. Tx were smaller than
A and older than H/W. The PWV of Tx differed only from H/W and
A/H. PWV-Z and PWV/h of Tx were increased compared to all
control groups. They correlated with the CaxP and cCTL before Tx
and were independent of age. Patients with creatinine clearance
> 90 ml/min/1.73 m(2) or < 1 year on dialysis had lower PWV-Z
and PWV/h than ESRD. Conclusion. Controls that matched for both
age and height should be used to assess PWV in children with
growth failure. PWV-Z is a universal age-independent parameter
of PWV in cases of growth retardation; PWV/h is a simple
alternative of PWV-Z. CaxP and cCTL are major determinants of
ASt after Tx. PWV may be reduced after Tx suggesting that the
uraemia-induced cardiovascular changes might be reversible.