[Cardiac characteristics of patients with terminal renal failure after kidney transplantation]

Left ventricular (LV) hypertrophy and dysfunction are risk factors for high mortality from cardiovascular causes in patients with end-stage renal disease. To determine the frequency of these findings after kidney transplantation, 45 patients (11 female, 34 male; age: 47.2 +/- 12 years) after transplantation (57 +/- 37 months) with (n = 21) and without (n = 24) a patent arteriovenous fistula were analyzed with echocardiography. A high prevalence of systolic (> 140 mm Hg: 40%) and diastolic (> 90 mm Hg: 18%) hypertension was observed despite the use of 1.44 +/- 0.9 (range: 0-3) antihypertensive drugs per patient. Most frequent echocardiographic findings were LV hypertrophy (78%; LV mass = 318 +/- 81 g), mostly in the asymmetric septal form (47%; mean ratio septal/posterior wall thicknesses: 1.38 +/- 0.2), and left atrial dilatation (60%; mean diameter: 44 +/- 6 mm). LV dilatation (33%; mean enddiastolic diameter: 53 +/- 5 mm) and systolic dysfunction (20%; mean ejection fraction: 64 +/- 11%) were less common. Individual values of LV mass were directly correlated with systolic blood pressure (p < 0.05). No relation was found between other echocardiographic (LV and left atrial diameters, LV mass, ejection fraction or velocity of circumferential fibre shortening) and clinical (transplantation duration, serum hemoglobin or creatinine, patency of dialysis access, or choice of immunosuppressive therapy) parameters. The presented data suggest that LV hypertrophy is frequent after renal transplantation, and that arterial hypertension is a key factor for the maintenance of LV hypertrophy in these patients, while the patency of the dialysis access, and the durations of transplantation or of preceding dialysis therapy are not relevant.(ABSTRACT TRUNCATED AT 250 WORDS)