Related Experiment Video
Updated: Jun 8, 2026
A Modified Surgical Technique for Kidney Transplantation in Mice
Published on: July 22, 2022
Long-term cardiovascular effects of pre-transplant native kidney nephrectomy in children
Marco Cavallini1, Giacomo Di Zazzo, Ugo Giordano
1Division of Pediatric Nephrology, Bambino Gesú Hospital, Rome, Italy.
Insights
Nephrectomy (surgical removal of kidneys) before kidney transplantation does not impact blood pressure control or left ventricular hypertrophy (LVH) after the procedure. This finding is crucial for managing cardiovascular health in pediatric ESRD patients.
Area of Science:
- Nephrology
- Cardiology
- Pediatric Medicine
Background:
- Left ventricular (LV) hypertrophy and hypertension are common in pediatric end-stage renal disease (ESRD) and post-renal transplantation.
- Severe hypertension historically led to native kidney nephrectomy before transplantation.
- The effect of nephrectomy on cardiovascular outcomes post-transplantation is not well understood.
Purpose of the Study:
- To evaluate the impact of native kidney nephrectomy on cardiovascular disease after renal transplantation in young adults.
- To compare blood pressure control and LVH prevalence between patients with and without nephrectomies.
Main Methods:
- Retrospective analysis of echocardiography and ambulatory blood pressure monitoring (ABPM) data.
- Study included 67 young adults transplanted in childhood with a mean 10.4-year follow-up.
- Patients were categorized based on unilateral, bilateral, or no nephrectomy.
Main Results:
- Pre-transplantation, nephrectomized groups used more antihypertensive drugs.
- At follow-up, antihypertensive medication use, mean arterial pressure (MAP), and LV mass index (LVMi) were similar between groups.
- Prevalence of LVH was comparable across non-nephrectomized (50%), unilateral nephrectomy (45.4%), and no native kidneys (44.4%) groups.
Conclusions:
- Unilateral or bilateral nephrectomies prior to renal transplantation do not appear to affect post-transplant blood pressure control or LVH prevalence.
- Further longitudinal studies assessing LVMi before and after transplantation are needed to understand the role of residual native kidney activity on cardiovascular changes.
Abstract:
Left ventricular (LV) hypertrophy (H) and hypertension are prevalent in children with end-stage renal disease (ESRD) and after renal transplantation. Severe hypertension prior to renal transplantation has traditionally been an indication for native kidney nephrectomy. The impact of nephrectomy on cardiovascular disease has not been well documented. We retrospectively evaluated echocardiographic and ambulatory blood pressure monitoring (ABPM) data in 67 young adults who had undergone transplantation in the pediatric age with a mean follow-up of 10.4 years. Unilateral or bilateral nephrectomies had been performed in 32 patients. The number of antihypertensive drugs used prior to transplantation was significantly higher in the nephrectomized groups. At follow-up the amount of antihypertensive medications was similar between groups and no significant differences were observed in mean arterial blood pressure (MAP) or LV mass index (LVMi). LVH was observed in 50% of non-nephrectomized patients, 45.4% of patients with unilateral nephrectomy, and 44.4% of patients without native kidneys (p = n.s.). In conclusion, unilateral or bilateral nephrectomies prior to transplantation do not appear to influence blood pressure control or the prevalence of LVH after renal transplantation. Longitudinal studies with repeated assessment of LVMi, before and after renal transplantation, are needed to assess the impact of residual activity of native kidneys on arterial blood pressure and cardiac structural changes, even in normotensive patients, to evaluate cardiovascular morbidity.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:29Acute Kidney Injury III: Clinical Manifestations