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Renal Allograft Function Is a Risk Factor of Left Ventricular Remodeling After Kidney Transplantation
1Transplantation Center, Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
Insights
Kidney transplant recipients with worsening kidney function show increased left ventricular hypertrophy. This suggests that declining allograft function contributes to cardiac remodeling after transplantation.
Area of Science:
- Nephrology
- Cardiology
- Transplantation Medicine
Background:
- Cardiovascular disease is a primary cause of death in kidney transplant recipients.
- Left ventricular hypertrophy prevalence rises with worsening kidney function.
Purpose of the Study:
- To investigate the link between declining kidney function and left ventricular hypertrophy post-kidney transplant.
- To analyze cardiac remodeling in relation to renal allograft function over time.
Main Methods:
- Retrospective review of kidney transplant patients from 1973-2009.
- Calculation of creatinine elevation ratio (CER) from 1 month to 5 years post-transplant.
- Comparison of left ventricular mass index (LVMI) between high-CER and low-CER groups.
Main Results:
- LVMI at 5 years post-transplant was significantly higher in the high-CER group (worsening renal function).
- LVMI increased in the high-CER group after initial decrease, unlike the low-CER group.
- No significant LVMI difference between groups at baseline or 1 year post-transplant.
Conclusions:
- Deterioration of kidney allograft function is associated with left ventricular remodeling.
- Monitoring renal function is crucial for assessing cardiac risk in transplant patients.
Background:
Cardiovascular disease is the leading cause of morbidity and mortality in kidney transplantation (KT) patients. The prevalence of left ventricular hypertrophy increases with the progression of renal insufficiency.
Methods:
We investigated the association between the progression of renal insufficiency and left ventricular hypertrophy after KT. We reviewed KT patients at Seoul National University Hospital from January 1973 to December 2009. The creatinine elevation ratio (CER, the percentage change in the creatinine level from 1 month to 5 years after transplant) was calculated as follows: (creatinine level at 5 years minus creatinine level at 1 month)/creatinine level at 1 month × 100.
Results:
The study population was classified into a high-CER group (CER ≥25%) and low-CER group (CER <25%). Mean left ventricular mass index (LVMI) values were 135.7 and 134.7 g/m2 before KT and 101.7 and 123.7 g/m2 at 5 years after KT in the low-CER and high-CER groups, respectively. The LVMI before or 1 year after KT was not different between the 2 groups, but the LVMI at 5 years post-transplant was higher in the high-CER group than in the low-CER group. The LVMI increased after its initial decrease in the high-CER group, whereas its reduction was maintained in the low-CER group during the 5 years after KT (P = .009, repeated-measures analysis of variance).
Conclusions:
These data suggest that deterioration of renal allograft function is associated with left ventricular remodeling after KT.
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01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management