Assessment of plasminogen activator inhibitor-1 and von Willebrand factor as a marers of endothelial function in patients with end-stage kidney disease after allotransplantation during a one-year follow-up

Objectives. The aim of our study was to determine the endothelial function in patients with chronic kidney disease (CKD), stage V (end-stage renal disease – ESRD), before and during a one-year observation after kidney allotransplantation. Patients and methods. We studied 40 patients with stabile graft function after their first kidney transplantation, including 21 females (mean age 41 ±12.5 yrs) and 19 males (mean age 43.6 ±13.3 yrs), treated already with hemodialysis because of ESRD. Results. After transplantation we observed significant decrease in serum creatinine concentrations (Cr) (7.32 ±2.07 mg/dl to 1.50 ±0.45 mg/dl at 6 months and 1.61 ±0.58 mg/dl after 12 months after transplantation). During 12 months we found changes only in plasminogen activator inhibitor-1 (PAI-1) levels. Von Willebrandt factor (vWF) levels remained unaltered during follow-up and total homocysteine (tHcy) concentration decreased, but this change was not statistically significant. There was no correlation between vWF and PAI-1 concentrations and other clinical and laboratory findings. Conclusions. In our study we did not find any improvement of endothelial function during the first year after kidney allotransplantation. The mean Cr concentration at the end of study was 1.6 mg/dl, which indicates the chronic kidney graft insufficiency. We conclude that despite kidney allotransplantation endothelial function is impaired like in CKD, but with more advanced abnormalities in the cardiovascular system.