Impact of Different Approaches to Kidney Transplant with and without Chronic Hemodialysis on Cardiac Function and Morphology: A Case–Control Study

Abstract

Patients with end-stage renal disease have higher cardiovascular morbidity and mortality compared with the general population. Preemptive kidney transplant (KTx) has been shown to be associated with improved survival, better quality of life, lower healthcare burden, and reduced cardiovascular risk. In this case–control study, we investigated the cardiovascular benefits of two approaches to KTx: with and without previous chronic hemodialysis. We enrolled 21 patients who underwent preemptive KTx and 21 matched controls who received chronic hemodialysis before KTx. Cardiac morphological and functional parameters were assessed by echocardiography. Overall, patients undergoing preemptive KTx showed less extensive cardiac damage compared with controls, as evidenced by higher global longitudinal strain, peak atrial and contractile strain, and early diastolic mitral annular velocity as well as a lower left ventricular mass, left atrial volume index, and the ratio of mitral inflow early diastolic velocity to the mitral annular early diastolic velocity. In the multivariable analysis, the presence of chronic hemodialysis prior to KTx was an independent determinant of post-transplant cardiac functional and structural remodeling. These findings may have important clinical implications, supporting the use of preemptive KTx as a preferred treatment strategy in patients with end-stage renal disease.

Changes in myocardial work associated with pediatric kidney transplantation: A pilot study of short‐term postoperative effect

“…Previous studies illustrated that increased incidence of cardiac function damage and graft kidney failure after KTx were found in patients undergoing chronic dialysis before KTx. 31 , 32 In addition, the BP had significance improvement after KTx and the decrease of BP was an independent factor to identified the improvement of LV MW parameters, which meant LV MW parameters take into account cardiac loading conditions and was consisted with the reported that GWI and GCW were significantly increased in the hypertensive patients, and independently associated with SBP in multivariable analysis. 33 Also changes of eGFR was negatively correlated with changes of GWE in this study.…”

T1 and T2 Mapping in Uremic Cardiomyopathy: An Update

“…Kidney transplantation (KT) has been described to have benefits on cardiac function and UC. [ 48 , 49 ] There are only a few studies investigating the longitudinal changes in native T 1 in patients undergoing KT, and the data are conflicting. In one study, native T 1 was described as increased 2 months after KT.…”