H LIEW1,2, M ROBERTS1,2, L MCMAHON1,2
1Department of Renal Medicine, Box Hill, Australia, 2Monash University, Melbourne, Australia
Background: The endothelial glycocalyx (EG) on the vascular luminal surface contributes to endothelial health and function. Damage to this layer is indicative of vascular injury, reflected by increased levels of its shed constituents in serum and an increase in the perfused boundary region (PBR) in sublingual capillaries using the novel Glycocheck device.
Aim: We aimed to examine the effects of kidney transplantation on the EG by measuring biochemical markers of the EG and endothelial dysfunction (ED), and the PBR.
Methods: We recruited patients with ESKD awaiting a kidney transplant. Investigations were performed before transplant, and then 1 and 3 months post transplantation. At each point, blood was collected for syndecan-1 (EG marker) and vascular cell adhesion molecule, VCAM (ED marker), urine for albumin:creatinine ratio (uACR) and a PBR measurement was performed.
Results: Thirteen patients were recruited with a mean age of 48.9 ± 12.6 years. At baseline, 1 month and 3 months post-transplant, syndecan-1 levels decreased from 139 ± 135ng/mL to 61 ± 91 (p=0.001) and 60 ± 86 (p=0.001) respectively. Similarly, VCAM-1 at baseline (1383 ± 447ng/mL) fell to 956 ± 465 (p=0.005) at 1 month and 931 ± 382 (p=0.006) at 3 months. Median (interquartile range) uACR levels decreased from 128 (5-364) mg/mmol at baseline to 7 (5-119) p=0.017 at 1 month and 9 (1-28) p=0.008 at 3 months. There was no PBR difference (2.11 ± 0.40, 2.07 ± 0.33, and 1.98 ± 0.20µm, respectively) at any time point.
Conclusion: Transplantation results in an improvement of EG and ED markers for up to 3 months post-transplant. No change in PBR was detected.
Renal Research Fellow