Affiliations: [a] Dipartimento chirurgico, medico, odontoiatrico e di scienze morfologiche, Università degli studi di Modena e Reggio Emilia, Modena, Italy
| [b] Divisione di Nefrologia, Dialisi e Trapianto Renale, Dipartimento di Medicina e Specialitá Mediche, Policlinico di Modena, Modena, Italy
Correspondence:
[*]
Corresponding author: Dr. Francesco Fontana, Divisione di Nefrologia, Dialisi e Trapianto Renale, via del Pozzo 71, 41124 Modena, Italy. Tel.: +39 0 594225269; Fax: +39 0 594222167; E-mail: [email protected].
Abstract: Uremic patients undergoing dialysis (HD) present a cardiovascular risk of death 10–20 fold higher than general population, but also kidney transplantation keeps considerable cardiovascular burden. Hemorheologic profile alterations have been described in HD; comprehensive data on kidney transplant recipients (KT) are missing. Aim of our study is to characterize the hemorheological profile in KT, and to compare these data with HD and healthy volunteers (HV). We investigated 47 HV, 90 HD and 108 KT. We confirm hemorheological alterations in HD. KT, when compared to HD, normalizes many parameters: plasma viscosity, whole blood viscosity at 1-Hz and 200-Hz shear rate, erythrocyte aggregation index and yield stress. KT show a markedly lower erythrocyte deformability (ED). We found no differences among hemorheological parameters between the different classes of immunosuppressive drugs used. In conclusion, HD show various hemorheological defects; this could support the high incidence of cardiovascular complications. KT improves most hemorheological alterations; nevertheless, ED is reduced in KT, maintaining a detrimental injury at microcirculatory level and leading to the progression of fibrosis till to end-stage injury. Impaired ED in KT could also contribute to progression of interstitial fibrosis and tubular atrophy (IF/TA) in grafts.
