Key result
Kidney transplantation is linked to significantly lower LVMI versus peritoneal dialysis.
Why the study?
CVD is the leading cause of death in dialysis patients and kidney transplant recipients, with LVH being a strong predictor of CVD; the authors hypothesised that kidney transplantation improves cardiovascular reserve.
Does kidney transplantation improve cardiovascular remodeling and left ventricular hypertrophy compared to peritoneal dialysis in patients with ESRD?
Case-Control (n=100)
No
Does kidney transplantation improve cardiovascular remodeling and left ventricular hypertrophy compared to peritoneal dialysis in patients with ESRD?
Kidney transplantation is associated with a significant reduction in left ventricular hypertrophy and improved diastolic function compared to long-term peritoneal dialysis.
Answers are grounded in this paper and cite their sources.
May support lower LV mass index with transplant versus peritoneal dialysis; hypothesis-generating, requires prospective confirmation before practice change.
Aims: Cardiovascular disease (CVD) is the leading cause of death in dialysis patients as well as in kidney transplant recipients (KTx). Left ventricular hypertrophy (LVH) starts early during the course of chronic kidney disease and is a strong predictor of CVD. We hypothesised that kidney transplant is significantly associated with improvement in cardiovascular reserve. We conducted a prospective study to compare changes in CV before and after kidney transplantation in patients with ESRD who received KTx to control individuals who received PD but did not receive a KTx. Study Design: A Case-Control Study. Place and Duration of Study: Clinic for nephrology Clinical Center University of Sarajevo, Bosnia and Herzegovina. Methodology: In this case-control study, we included 50 KTx from the Kidney Transplant Outpatient Clinic for nephrology Clinical Center. For each 50 KTx, PD outpatients matched for gender and age were recruited. All patients underwent transthoracic echocardiography, and LV (left ventricular) mass (LVM), LV mass index (LVMi), and indices of cardiac function were measured. In the small subgroup of 18 KTx, we retrospectively assessed and compared the LVMI measurements, during dialysis and the post-transplant period. Results: The prevalence of LVH was 24% in KTx patients and 72% in PD patients (NS). KTx had significantly lower LVM, LVMi levels, E/A ratio, FS, and LA diameter compared with the PD group, while the EF and other echocardiographic parameters did not differ. In the subgroup of 18 KTx, LVMi levels after transplantation were significantly lower than dialysis LVMi levels. Conclusion: LVH is the most frequent cardiac abnormality at the time of kidney transplantation. After KTx, the reduction of LVH and diastolic dysfunction was significant. CV remodelling after successful KTx is related to better kidney function, and can explain better outcomes for patients with kidney transplants over patients on long-term dialysis.
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Damir et al. (2023) conducted a case-control in End-stage renal disease (n=100). Kidney transplantation vs. Peritoneal dialysis was evaluated on Prevalence of left ventricular hypertrophy (p=NS). Kidney transplantation was associated with a lower prevalence of left ventricular hypertrophy compared to peritoneal dialysis and lower left ventricular mass index.
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