Left Ventricular Hypertrophy in Kidney Transplant Recipients in Sub-Saharan Africa

Abstract

Background: Left ventricular hypertrophy (LVH) is present in 67-70% of patients on chronic dialysis and in up to 40-60% of kidney transplant recipients (KTRs) and is associated with graft dysfunction. We determined the prevalence of LVH and its association with graft function among KTRs in a South African transplant center. Materials and Methods: Adult recipients of kidney transplant at the Charlotte Maxeke Johannesburg Academic Hospital between January 2005 and December 2009 were recruited. Patients' records were assessed for information on their posttransplant follow-up. All patients had transthoracic echocardiography and carotid Doppler done for assessment of cardiac status and carotid intima-media thickness (CIMT) respectively. Graft dysfunction was defined as estimated glomerular filtration rate of <60 ml/min/1.73 m 2 based on the modification of diet in renal disease formula. Inferential and modeling statistics were applied as appropriate using SPSS, and P ≤ 0.05 considered significant. Results: One hundred KTRs underwent echocardiography. There were 63% males, and the mean age of the study population was 42.2 ± 12.42 with a range of 19-70 years. The mean duration posttransplant was 59.28 ± 18.59 months with a range of 36-84 months. LVH was present in 76% of the study population; 51% had concentric LVH, and 25% had eccentric LVH. Graft dysfunction was found in 52%. Risk factors for LVH were longer duration on dialysis P = 0.017, cigarette smoking P = 0.032, increased CIMT P = 0.05, higher cumulative steroid dose P < 0.0001 and increased waist circumference P = 0.03. LVH was associated with graft dysfunction, χ2 = 9.22, P = 0.008. Conclusion: LVH is prevalent in our KTRs and is associated with graft dysfunction.