Kidney Week

Abstract: TH-PO1011

From Large Arteries to Retinal Arterioles: Improvement of Vascular Remodeling After Kidney Transplantation

Session Information

• Transplantation: Clinical - Outcomes, Malignancy, and Pathology
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Kannenkeril, Dennis, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Dennis Kannenkeril, MD

• Heller, Katharina M., Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Katharina M. Heller, MD

• Bosch, Agnes, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Agnes Bosch, MD

• Striepe, Kristina, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Kristina Striepe, MD

• Bytyqi, Venera, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Venera Bytyqi, MD

• Günes-Altan, Merve, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Merve Günes-Altan

• Kliem, Thorsten, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Thorsten Kliem, MD, DrMed

• Schiffer, Mario, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Mario Schiffer, MD, MBA

• Schmieder, Roland E., Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Roland E. Schmieder, MD, FASN

Background

Renal transplantation is the preferred treatment for patients with end-stage kidney disease, as it is associated with reduced cardiovascular morbidity and mortality compared to chronic dialysis. Our previous findings showed early macrocirculatory improvement after renal transplantation, whereas no concomitant improvement in the microcirculation was observed. The aim of the present study was to analyze long-term changes in various parameters of the macro- and microcirculation following renal transplantation in the same cohort.

Methods

All patients underwent vascular examination both before and one year after renal transplantation. Vascular function and structure in the macrocirculation were measured with the SphygmoCor XCEL System. Retinal capillary flow, wall-to-lumen ratio, vessel and lumen diameter, wall thickness of retinal arterioles—reflecting microcirculatory parameters—were evaluated using Scanning Laser Doppler Flowmetry (SLDF).

Results

Forty-three patients with end-stage kidney disease (mean age 44.5 ± 14.8 years) were followed for one year after renal transplantation. The estimated glomerular filtration rate at 12 months post-transplant was 48.4 ± 14.4 ml/min/1.73 m². Pulse wave velocity, central systolic pressure and peripheral pulse pressure decreased significantly following transplantation (table 1), in parallel with reductions in office systolic (p<0.001) and diastolic blood pressure (p=0.006). Twelve months post-transplant relevant improvement were observed wall thickness, wall to lumen ratio and wall cross-sectional area of retinal arterioles (table 1).

Conclusion

Our findings suggest a sequential pattern of vascular recovery after renal transplantation, with early macrocirculatory improvement (windekessel function) followed by later improvement in microvascular remodeling.