Key result
Kidney transplantation significantly reduced left ventricular mass index and improved ejection fraction and apical 4-chamber strain in patients with end-stage renal disease after 1 month.
Why the study?
Does kidney transplantation improve echocardiographic parameters of myocardial function and structure in patients with ESRD on hemodialysis?
Observational (n=25)
Single-blind (outcome assessors)
No
Does kidney transplantation improve echocardiographic parameters of myocardial function and structure in patients with ESRD on hemodialysis?
Mean Difference: -73.82
Absolute Event Rate: 92% vs 148.5%
p-value: p=<0.001
Kidney transplantation in hemodialysis patients leads to early improvements in myocardial structure and function, including ejection fraction, LV mass index, and apical 4-chamber strain, detectable by speckle tracking echocardiography as early as 1 month post-transplant.
Supports early cardiac recovery post-transplant in ESRD; extends observational data but remains hypothesis-generating and should not yet change practice.
Introduction: Cardiac dysfunction is a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD). Previous studies have shown that kidney transplantation can reverse some of the gross changes in the myocardial structure such as left ventricular ejection fraction (LVEF) and volumes. Whether kidney transplantation can reverse the subtle and early myocardial changes in ESRD patients who do not suffer from gross alternations in myocardial function is not yet studied. The aim of this study was to answer this question. Methods: We followed 25 patients with ESRD at baseline that all of them had a kidney transplant and were reassessed 1 month after the transplantation. Conventional and speckle tracking echocardiography (STE)was done at baseline and 1 month after kidney transplantation in patients. Results: LV hypertrophy was the most prevalent finding at baseline (58%), followed by diastolic dysfunction (53%). Kidney transplantation significantly improved the ejection fraction (EF) (treatment effect = 4.23 ± 2.06%; P = 0.046) and apical 4-chamber strain (treatment effect = -0.89 ± 0.37%; P = 0.021) in the patients. It also reduced the LV mass index (treatment effect = -73.82 ± 11.6; P < 0.001) and relative wall thickness (treatment effect = -0.056±0.023; P = 0.021). Other variables including global longitudinal strain and diastolic dysfunction were not improved significantly. Conclusion: STE may show early improvements in myocardial function 1 month after renal transplantation.
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Hamidi et al. (2018) conducted an observational in End-stage renal disease (n=25). Kidney transplantation vs. Baseline (pre-transplantation) was evaluated on Left ventricular mass index (LVMI) (MD -73.82, p=<0.001). Kidney transplantation significantly reduced left ventricular mass index and improved ejection fraction and apical 4-chamber strain in patients with end-stage renal disease after 1 month.
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