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Longitudinal Changes in Cardiac Structure and Function in Pediatric Kidney Transplant Recipients
Isabel de Verteuil1, Jessica Fitzpatrick1, Ana Catalina Alvarez Elias2,3
1Child Health Evaluative Sciences, Research Institute (I.d.V., J.F., T.B., J.V.-R., J.B., B.C.B., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada.
Hypertension (Dallas, Tex. : 1979)
|June 2, 2022
Summary
Pediatric kidney transplant recipients experienced improved cardiac structure and function post-transplant. Strict blood pressure control is crucial for normalizing cardiac changes and reducing long-term risks.
Area of Science:
- Pediatric Nephrology
- Cardiology
- Transplantation Medicine
Background:
- Cardiovascular disease is a significant cause of morbidity and mortality in pediatric kidney transplant recipients.
- Longitudinal data on cardiac structure, function, and blood pressure control post-transplant are lacking.
Purpose of the Study:
- To investigate the influence of blood pressure control on cardiac remodeling after kidney transplantation in children.
- To analyze longitudinal changes in cardiac structure and function in this population.
Main Methods:
- Retrospective cohort study of 142 pediatric kidney transplant recipients (2004-2015).
- Cardiac parameters assessed via echocardiography; blood pressure control evaluated using Z-scores and antihypertensive medication.
- Segmented mixed-effects models analyzed changes in interventricular septum, left ventricular dimensions, and mass.
Main Results:
- All cardiac structural Z-scores improved post-transplant, with normalization occurring within 1.5 to 6.3 years.
- Left ventricular mass index showed sustained improvement up to 12 years.
- Uncontrolled blood pressure was associated with increased left ventricular mass (β=2.97).
Conclusions:
- Cardiac abnormalities significantly improve and normalize within 7 years after kidney transplantation in children.
- Maintaining strict blood pressure control is essential for optimal cardiac outcomes post-transplant.
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