Effects of Renal Transplantation on Cardiac Morphology and Function Luis Vernaza Hospital, Guayaquil, Ecuador: Kidney Transplant and Morphology and Cardiac Function

Abstract

Introduction: Structural heart disease is a frequent complication of advanced chronic kidney disease and the leading cause of death in patients with renal replacement therapy, mainly in those on dialysis. There is sufficient evidence to demonstrate a regression of left ventricular hypertrophy and improvement of ventricular function after a successful renal transplant. The objective of this study is to describe the experience regarding the effects of renal transplantation on cardiac remodeling and function and thus corroborate with local data the benefits of renal transplantation on the left ventricular mass index (LVMI grs), Left Ventricle Ejection Fraction (LVEF %), Left Atrium Diameter (LAD mm), Left Ventricle Diastolic Diameter (LVDD mm), Left Ventricle Systolic Diameter (LVSD mm), Posterior Wall (PW mm) and Interventricular Septum (IVS mm). Materials and Methods: This is a quantitative, observational, descriptive and retrospective study. A database was constructed whose information was tabulated and subsequently analysed by the statistical program SPSS 13 to perform the statistical analysis. The results of the nominal variables were expressed in percentages and of the numerical variables in average ± standard deviation (SD) and confidence interval. The study included all adults over18 years with a diagnosis of chronic renal failure who underwent renal transplantation at Luis Vernaza Hospital between January 2009 to December 2016 and who had pre and post-transplant transthoracic echocardiography. Results: Of the 132 adults undergoing renal transplantation, 74 patients who met the inclusion criteria were identified, their average age was 35.2 years DS (+/- 11.7 years), forty-eight patients (64%) were male. All patients were dependent on dialysis, whose average time was 5 years and 88% of the population underwent intermittent hemodialysis weekly. The pre-transplant and post-transplant echocardiographic measurements were: LVEF (%) 60.89 ± 1,175 vs. 66.81 ± 0.685 (<0.0001); LVMI (grs) 242.54 ± 11.92 vs. 184.62 ± 7,591 (<0.0001); LAD (mm) 35.9 ± 0.772 vs. 34.8 ± 0.602 (0.215); LVDD (mm) 47.97 ± 0.756 vs. 44.98 ± 0.927 (0.003); LVDS (mm) 29.85 ± 0.897 vs. 26.68 ± 0.681 (0.004); PW (mm) 11.86 ± 0.270 vs. 10.92 ± 0.208 (0.002); IVS (mm) 12.12 ± 0.348 vs. 10.95 ± 0.253 (0.002) respectively. Conclusion: In this study, was observed a favorable overall impact of renal transplantation on the structure and function of the heart, with a significant reduction in LVH and LVMI and systolic and diastolic function of the left ventricle, thus reducing the risk of associated death to cardiovascular events.