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Abstract: PO2132

Cerebrovascular Response in Kidney Transplant Recipients During an Acute Bout of Exercise

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Ramakrishnan, Madhuri, University of Kansas Medical Center, Kansas City, Kansas, United States
  • Ward, Jaimie, University of Kansas Medical Center, Kansas City, Kansas, United States
  • Jurgensen, Andrew J., University of Kansas Medical Center, Kansas City, Kansas, United States
  • Billinger, Sandra, University of Kansas Medical Center, Kansas City, Kansas, United States
  • Gupta, Aditi, University of Kansas Medical Center, Kansas City, Kansas, United States
Background

Kidney transplant (KT) recipients have a high risk of cerebrovascular disease. Cerebrovascular response (CVR) or change in cerebral blood flow (CBF) from rest to steady-state exercise is a measure of cerebrovascular reserve and is blunted with aging, and in stroke. In this study we explore CVR and middle cerebral artery (MCA) kinetics response in KT recipients.

Methods

We measured CVR and MCA kinetics response during moderate intensity exercise in KT recipients and compared findings with age- and sex- matched controls without kidney disease. Transcranial doppler ultrasound (TCD) was used to measure MCA velocity (MCAv). Our primary outcome was CVR and secondary outcome was MCAv kinetics response profile.

Results

Data from 50 KT recipients and 50 controls with adequate TCD signal were analyzed. There was no difference in the resting MCAv between KT recipients and controls, but CVR was lower in KT recipients (p< 0.001) (Table 1). Three KT recipients did not have a detectable rise in MCAv with exercise. The remaining 47 showed altered MCAv kinetics response profile compared to controls with a shorter time delay (time after exercise onset when MCAv rises exponentially) (p< 0.001), and lower peak amplitude (peak MCAv in response to the acute bout of exercise) (p= 0.01) (Table 1; Figure 1).

Conclusion

KT recipients had a blunted CVR and altered MCAv kinetics response during moderate intensity exercise compared to controls. These altered cerebral hemodynamics may explain the increased cerebrovascular risks in KT recipients.

Table 1
Outcome measuresHealthy ControlsKT RecipientsP value
Resting MCAv (cm/s)53.1 ± 9.255.7 ± 14.60.31
CVR (cm/s)12.4 ± 5.79.1 ± 4.9< 0.001
Time delay (s)50.6 ± 30.722.6 ± 41.2< 0.001
Peak amplitude (cm/s)12.2 ± 5.79.3 ± 4.30.01

Values are means ± SD.

Figure 1

Funding

  • Other NIH Support