Does kidney transplantation improve left-ventricular mass index in patients with end-stage kidney disease?
Kidney transplantation is associated with significant reductions in left-ventricular mass index compared to pre-transplantation levels, which may contribute to the lower cardiovascular risk observed in these patients.
BACKGROUND Cardiovascular disease is the leading cause of death in end-stage kidney disease and the chronic cardiomyopathy of chronic kidney disease contributes significantly to this. Kidney transplantation (KTx) is associated with improved survival compared to dialysis. This systematic review and meta-analysis (CRD42022371202) aimed to assess the changes in echocardiographic indices in patients before and following KTx. METHODS Literature search involved PubMed, Web-of-Science and Scopus databases, manual search of article references and grey literature. The primary outcome measure was left-ventricular mass index (LVMI). RESULTS 33 studies with 2,364 patients were included in the metanalysis for the primary outcome. LVMI was significantly decreased after KTx compared to pre-transplantation values WMD -21.99 g/m2, 95%CI (-28.10, -15.87) I2=89%, P6 months after KTx [WMD -18.96 g/m2, 95%CI (-25.44, -12.47), I2=89%, P<0.001. In sensitivity analyses, patients receiving kidney from living kidney donors (WMD; -76.90 g/m2, 95%CI (-122.13, -31.67), I2=88%, P<0.001) and those on hemodialysis before KTx WMD;-33.76 g/m2, 95%CI (-51.51, -16.00), I2=92% P<0.001 presented higher LVMI reductions following transplantation. CONCLUSIONS KTx is associated with significant reductions in LVMI compared to the pre-transplantation levels. This could be another factor contributing to the lower cardiovascular risk observed after KTx compared to dialysis.
Betsikos et al. (Sun,) studied this question.