Relationship Between Epicardial Adipose Tissue, Inflammation and Volume Markers in Hemodialysis and Transplant Patients

Abstract

Cardiovascular (CV) diseases are still the most important cause of morbidity and mortality in both patients receiving hemodialysis (HD) treatment and individuals with renal transplantation (Rtx). Measurement of epicardial adipose tissue (EAT) thickness is an easily applied, cheap, and useful recent method predicting increased CV risk. We aimed to compare EAT changes in HD and Rtx patients and the association between EAT and inflammatory and CV volume markers in both groups. A total of 124 patients: 45 Rtx, 43 HD patients and 36 healthy controls were enrolled in the study. Laboratory parameters and inflammatory markers (interleukin-6 [IL-6] and high sensitive C-reactive protein [Hs-CRP]) were evaluated from venous blood samples after an overnight fast. EAT thickness was measured with transthoracic echocardiography. The levels of Hs-CRP, IL-6, systolic and diastolic blood pressures, left atrial (LA) diameter, left atrial index (LAI), left ventricular mass (LVM) and LVM index (LVMI) were significantly higher in the HD patients than in the other groups. EAT was positively correlated with age, body mass index (BMI), time on dialysis, serum creatinine, total cholesterol, Low density lipoprotein-cholesterol, and LVM in Rtx group and positively correlated with age, BMI, duration of dialysis, Hs-CRP, IL-6, LAI and LVMI and inversely correlated with inferior vena cava collapse index (IVC-CI) in HD group. EAT thickness of RTx patients (whose previous HD duration was similar to those in HD group) are similar to the healthy population and significantly thinner than patients on HD.

Adiponectin, leptin, nitric oxide, and C-reactive protein levels in kidney transplant recipients: comparison with the hemodialysis and chronic renal failure

“…In line with our finding, Kimak et al 59 found increased TG levels in KT patients than those of the controls. However, Tsai et al 47 reported increased TC levels and C¸olak et al 60 did not find any significant differences between the KTR, HD, and the control groups.…”

Serum paraoxonase activity is associated with epicardial fat tissue in renal transplant recipients

“…After the suggestion of EFT use in the prediction of CVD risk assessment, Karohl et al [39] reported that EFT may be useful and correlated with myocardial perfusion for screening CKD patients prior to renal transplantation in order to predict future cardiovascular risk. Only one report by Colak et al [17] assessed the role of EFT in renal transplant patients and they concluded that EFT is correlated with left ventricle mass index.…”

“…It has been well established that EFT is a predictor of CVD in both non uremic and uremic populations, such as in peritoneal dialysis (PD) and hemodialysis (HD) patients [14][15][16]. However, only one study mentioned that EFT is lower in RT recipients compared to HD patients [17]. At present there are not enough data about EFT and cardiovascular disease in RT recipients.…”

Systolic and Diastolic Epicardial Adipose Tissue Thickness in Non-Dialysis Dependent Chronic Kidney Disease Patients: Technique, Correlates and Cardiovascular Outcomes (The EAT CKD study)

“…41,42 Recent studies have shown that EAT is potentially modifiable in hemodialysis (HD) patients. Wilund et al 43 showed EAT thickness could be reduced with exercise and Colak et al 44 showed EAT thickness was significantly reduced in renal transplant patients. Experimental treat-…”