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Echocardiographic abnormalities in patients on kidney transplant waiting list

Sofia G Rocha1, Nihil Chitalia, Helen Gregson

  • 1Renal and Transplantation Unit, St George's Hospital, University of London, London, UK. sofiarocha81@gmail.com

Journal of Nephrology
|March 3, 2012
PubMed

Insights

Patients awaiting kidney transplantation experience worsening cardiac structure, specifically increased left ventricular mass index and left atrium diameter. These changes predict cardiovascular events and mortality in this high-risk population.

Area of Science:

  • Cardiology
  • Nephrology
  • Echocardiography

Background:

  • Chronic kidney disease (CKD) is linked to echocardiographic abnormalities, cardiovascular events (CVEs), and mortality.
  • Progression of cardiac abnormalities in patients awaiting kidney transplantation is not well understood.

Purpose of the Study:

  • To assess the progression of echocardiographic variables in patients on the kidney transplant waiting list.
  • To identify predictors of CVEs and mortality in this cohort.

Main Methods:

  • Retrospective analysis of 79 patients awaiting kidney transplantation (2004-2010).
  • Repeat echocardiograms at least 1 year apart and at least 1 year post-transplant.
  • Analysis of echocardiographic variables and clinical outcomes.

Main Results:

  • Significant increases in left ventricular mass index (LVMI) and left atrium (LA) diameter observed in patients remaining on the waiting list.
  • No significant changes in left ventricular fractional shortening (FS) or dimensions.
  • LA diameter, systolic dysfunction, and LVMI independently predicted CVEs and mortality.

Conclusions:

  • Waiting time for kidney transplantation is associated with progressive cardiac structural changes.
  • Increased LA diameter and LVMI are markers of adverse outcomes in pre-transplant patients.
Abstract

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