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Midterm echocardiographic follow-up of cardiac function after living kidney donation
Bernd Hewing1, Henryk Dreger, Fabian Knebel
1Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, and Medizinische Klinik für Nephrologie, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.
Insights
Living kidney donation (LKD) shows no immediate negative impact on donor heart function, despite increased blood pressure and creatinine levels. Further research is needed to confirm long-term safety for kidney donors.
Area of Science:
- Nephrology
- Cardiology
- Transplantation
Background:
- Living kidney donation (LKD) is crucial for end-stage renal disease patients.
- Concerns exist regarding potential increased cardiovascular mortality post-LKD.
- Donor safety is paramount in kidney donation procedures.
Purpose of the Study:
- To evaluate cardiac structure and function changes after LKD.
- To assess the short-term cardiovascular impact on living kidney donors.
- To utilize advanced echocardiographic methods for precise measurements.
Main Methods:
- 30 living kidney donors underwent medical exams, lab tests, and echocardiography pre- and post-donation.
- Standard echocardiographic indices assessed left ventricular (LV) and right ventricular (RV) function.
- 2D speckle tracking analyzed LV and left atrial (LA) longitudinal strain.
Main Results:
- Serum creatinine significantly increased post-LKD (0.80 to 1.18 mg/dL).
- A trend towards higher blood pressure and increased antihypertensive drug use was observed.
- No significant changes in LV, LA, or RV function parameters were detected by echocardiography.
- N-terminal pro-brain natriuretic peptide (NT-proBNP) levels remained normal.
Conclusions:
- Elevated creatinine and blood pressure suggest potential long-term cardiac risk for kidney donors.
- This pilot study found no evidence of short-term detrimental effects on cardiac structure or function after LKD.
Background:
Living kidney donation (LKD) has become increasingly important as more patients reach end-stage renal disease. While safety of the donor is of utmost importance, recent data have suggested an increased risk for cardiovascular mortality after LKD. Therefore, we assessed the changes of cardiac structure and function after LKD by advanced echocardiographic methods.
Methods:
30 living kidney donors were evaluated by medical examination, laboratory testing, and echocardiography before and after LKD (median follow-up 19.5 months). Left ventricular (LV) and right ventricular (RV) function was assessed by echocardiographic standard indices. Longitudinal 2D strain of the LV and left atrium (LA) was determined by 2D speckle tracking.
Results:
Serum creatinine increased significantly from 0.80 ± 0.12 mg/dL to 1.18 ± 0.21 mg/ dL (p < 0.001) after LKD. There was a trend to higher blood pressure after LKD, accompanied with significantly higher intake of antihypertensive drugs. Echocardiographic parameters of LV, LA, and RV function did not change significantly after LKD. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels remained within normal ranges after LKD.
Conclusion:
The rise in serum creatinine and blood pressure indicates that patients have a potentially higher cardiac risk after LKD. However, our pilot study found no evidence for detrimental effects of LKD on cardiac structure and function within a relatively short-term follow-up.
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