Related Experiment Video
Updated: Jun 3, 2025
A Mouse 5/6th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy
Published on: November 7, 2017
Recovery of Myocardial Functions After Kidney Transplantation in Patients with Heart Failure Due to Uremic
Yelda Saltan Özateş1, Ahmet Yener Odabaşı2, Ufuk Yıldız1
1Department of Cardiology, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Türkiye.
Insights
Kidney transplantation significantly improves heart function in patients with heart failure due to uremic cardiomyopathy. This study shows uremic cardiomyopathy is reversible with successful kidney transplants.
Area of Science:
- Nephrology
- Cardiology
- Transplantation
Background:
- Left ventricular hypertrophy is common in end-stage renal disease.
- Heart failure with reduced ejection fraction (HF-rEF) occurs in some patients.
- Kidney transplantation (KT) is often avoided in HF-rEF patients due to increased mortality risks.
Purpose of the Study:
- To investigate the impact of kidney transplantation on heart function in patients with HF-rEF due to uremic cardiomyopathy (UC).
- To assess the reversibility of UC following successful KT.
Main Methods:
- Prospective study comparing three groups: HF patients receiving KT (Group 1), KT candidates with normal ventricular function (Group 2), and HF patients not receiving KT (Group 3).
- Evaluated left ventricular ejection fraction (LVEF), left atrial diameter (LAD), mitral annular systolic velocity (Sm), left ventricular global longitudinal strain (GLS), and left ventricular mass index (LVMI) pre- and post-transplant.
- Cardiac MRI and endomyocardial biopsy were performed for myocardial assessment.
Main Results:
- Group 1 showed significant improvements in LVEF, Sm, and GLS, with decreases in LAD and LVMI, reaching normal levels post-KT.
- Groups 2 and 3 exhibited no significant changes in these cardiac parameters.
- Cardiac MRI and biopsy findings were similar between Group 1 and Group 3 pre-transplant.
Conclusions:
- Successful kidney transplantation leads to significant improvement and normalization of myocardial function in patients with HF-rEF due to UC.
- Uremic cardiomyopathy is a reversible condition when treated with kidney transplantation.
Objective:
Although left ventricular hypertrophy frequently accompanies end-stage renal disease, heart failure (HF) with reduced ejection fraction (EF) is also observed in a subset of patients. In those patients kidney transplantation (KT) is generally avoided due to an increased risk of mortality in addition to the risks associated with HF. This prospective study was designed to follow patients with HF who were being prepared for KT.
Methods:
Twenty-five patients with HF due to uremic cardiomyopathy (UC) who had suitable donors (Group 1), 22 patients with HF who could not undergo KT due to a lack of kidney donors (Group 3), and 25 KT candidates with normal ventricular function (Group 2) were included in the study. Left ventricular ejection fraction (LVEF), left atrial diameter (LAD), mitral annular systolic velocity (Sm), left ventricular global longitudinal strain (GLS), and left ventricular mass index (LVMI) values were recorded across four sessions, from pre-transplant to six months post-transplantation. Endomyocardial biopsy was performed for detailed examination of the myocardium in patients in Group 1 and Group 3, and cardiac magnetic resonance imaging (MRI) was performed in all three groups before transplantation.
Results:
In Group 1, LVEF, Sm, and left ventricular global longitudinal strain (LV-GLS) increased significantly, while LAD and LVMI decreased, all reaching normal levels. In contrast, no changes were observed in Group 3 and Group 2 (P < 0.01 for LVEF, P < 0.01 for GLS, P < 0.01 for LAD, and P < 0.01 for LVMI measurements). No differences in cardiac MRI and biopsy findings were observed between Group 1 and Group 3.
Conclusion:
Since myocardial function improved significantly and normalized in all patients with HF, it has been demonstrated that UC can be substantially reversible when treated with KT.
Related Concept Videos
01:22Heart Failure Drugs: Diuretics
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:17Pathophysiology of Heart Failure