MON-192 PERIPHERAL ARTERIAL DISEASE BEFORE AND AFTER RENAL TRANSPLANTATION

The data on the prevalence and associated risk factors of sub-clinical peripheral arterial disease (PAD) in renal transplant recipients is scant. All renal allograft transplantations done over a period of one year were included. Peripheral arterial disease and associated risk factors were studied before and ≥ 6 months after renal transplant surgery. Peripheral arterial disease was studied noninvasively using ankle brachial index (ABI). Peripheral arterial disease was considered if ABI was <0.09. Fifty-three live related renal allograft surgeries were carried out in one year. Four patients (2 deaths, 2 lost to follow-up) were excluded from the study. Forty-nine (49) patients (43 male and 6 female) with a mean age of 36±14 years were included. Diabetic nephropathy (32.7%) was the commonest cause of chronic kidney disease followed by chronic glomerulonephritis (20.4%), hypertensive nephrosclerosis (16.3%), reflux nephropathy (8.2), chronic interstitial disease and obstructive nephropathy 8.1% each and autosomal dominant polycystic kidney disease (4.1%). The mean values of ABI were 1.08±0.12 before and 1.07±0.11 after renal transplantation (p=0.287). Peripheral arterial disease was present in 6 (12.2%) of cases both pre and post renal transplant. None of the patients had ABI >1.3. As compared to patients without PAD, patients with peripheral arterial disease had higher mean age (p=0.270), higher body mass index (p=0.004) and were smokers (p=0.031), with comorbidities of hypertension, diabetes mellitus or both (p=0.025) and had dyslipidemia (p=0.027). After renal transplantation, there was a significant elevation in the mean values of serum cholesterol (p=0.036), HDL (p=0.0002) and triglycerides (p=0.0002). However, the lipid profile in renal allograft recipients with peripheral arterial disease was not significant when compared to those without peripheral arterial disease. Peripheral arterial disease occurred in 12% of patients with end stage kidney disease. There was no change in the prevalence of peripheral arterial disease after renal transplantation at ≥ 6 months follow-up. A longer follow-up is needed to find out any impact of renal transplantation on the profile of peripheral arterial disease.