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- Title
Time-dependent changes in cardiac growth after kidney transplantation: the impact of pre-dialysis ventricular mass.
- Authors
Domingo Hernández; Ana González; Margarita Rufino; Ignacio Laynez; Alejandro de la Rosa; Esteban Porrini; Juan Lacalzada; Antonio Barragán; Víctor Lorenzo; Armando Torres
- Abstract
Background. Left ventricular hypertrophy (LVH) is common in chronic kidney disease (CKD), including kidney transplant recipients. However, time-related left ventricular mass changes (△LVM) from pre-dialysis stage to beyond the first post-transplant year have not been clearly identified. Methods. We studied a cohort of 60 stages 4–5 CKD patients without overt cardiac disease, who underwent three echocardiograms during follow-up: at pre-dialysis stage, on dialysis and after kidney transplantation (KT). Multiple linear regression was used to model △LVM from baseline study. Cox proportional analysis was used to determine risk factors associated with either de novo LVH or >20% △LVMI over time. Results. Patients with baseline LVH (n = 37; 61%) had a higher body mass index (BMI) than those without LVH (n = 23; 39%) (P = 0.013). BMI, haemoglobin levels (P = 0.047) and non-use of angiotensin-converting enzyme inhibitors (ACEI) (P = 0.057) were associated with baseline left ventricular mass index (LVMI). Twelve out of 23 patients (52%) with normal LVM at baseline, developed either de novo LVH or >20% △LVMI at follow-up. On the other hand, 29 (78%) of those with initial LVH maintained this abnormality, and 8 (22%) normalized LVM post-transplantation. Factors associated with △LVMI were age (P = 0.01), pre-dialysis LVMI (P P = 0.012) and the use of ACEI post-transplantation (P = 0.009). In Cox analysis, pre-dialysis LVMI was associated with de novo LVH or >20% △LVMI over time (hazard ratio 1.009; 95% confidence interval 1.004 to 1.015; P = 0.001). Conclusions. Successful KT may not completely normalize LVM post-transplantation. Pre-dialysis LVMI, traditional risk factors and no use of ACEI may perpetuate cardiac growth following KT.
- Subjects
DIALYSIS (Chemistry); FILTERS &; filtration; DIFFUSION; OSMOSIS
- Publication
Nephrology Dialysis Transplantation, 2007, Vol 22, Issue 9, p2678
- ISSN
0931-0509
- Publication type
Article
- DOI
10.1093/ndt/gfm247