Cardiac Remodeling in Structure and Function Six Months After Kidney Transplantation

Abstract

BackgroundCardiovascular disease accounts for 35% to 50% of the causes of mortality in chronic kidney disease. The majority of patients in substitution therapy in Mexico are subdialyzed owing to limited economic resources. This produces more cardiac deterioration than described in the statistics and has a direct impact on the prognosis of kidney transplantation. The aim of this work was to demonstrate and to quantify the improvement in the echocardiographic parameters 6 months after renal transplantation in patients with stable renal function. MethodsThis was an observational, analytic, prospective study of 23 patients with chronic kidney disease who received transplants in 2016 and had a glomerular filtration rate ≥80 mL/min (Chronic Kidney Disease–Epidemiology Collaboration) 6 months after transplantation. ResultsEchocardiographic results showed an increase in the left ventricular ejection fraction from 57.17 ± 10.46% to 64.09 ± 9.8%, an increase in the right ventricular ejection fraction from 0.56 ± 0.09% to 0.60 ± 0.08% and a reduction of the pulmonary arterial systolic pressure from 44.57 ± 13.88 mm Hg to 39.74 ± 11.04 mm Hg. There were also decreases in mitral regurgitation from 1.0 to 0.43, tricuspid insufficiency from 1.35 to 0.43, pulmonary insufficiency from 0.48 to 0.04, and aortic insufficiency from 0.35 to 0.04, all of these significant with P < .05. ConclusionsThere was a significant improvement in cardiovascular function in our population 6 months after transplantation, despite the fact that renal transplantation is performed with greater cardiac deterioration than described in patients in other countries.