Abstract
Background: Patients on dialysis have impaired cardiac function, in part due to increased fluid volume and ventricular stress. Restored kidney function through transplantation reduces left ventricular volume in both systole and diastole. We previously reported that the decrease in NT-proB-type natriuretic peptide (NT-proBNP) was associated with a decrease in adiponectin. Paraoxonase 1 (PON1) has been inversely associated with cardiovascular outcomes. We now report the association of changes in PON1 with changes in left ventricular volume and left ventricular mass after kidney transplantation.Design: Patients on dialysis were assessed at baseline and 12 months after kidney transplantation (n = 38). A comparison group of patients on dialysis who were not expected to receive a transplant in the next 24 months were studied (n = 43) to determine if the change of PON1 with kidney transplantation achieved a significance greater than that due to biologic variation. Left ventricular volume and mass were determined by cardiac magnetic resonance imaging. PON1 was measured by arylesterase activity and by mass.Results: PON1 mass and activity were not different between the groups at baseline. Both PON1 mass and activity were increased post-kidney transplantation (p < 0.0001 for change). The change in PON1 mass (p = 0.0062) and PON1 arylesterase activity (p = 0.0254) were inversely correlated with the change in NT-proBNP for patients receiving a kidney transplant. However, only the change in the PON1 mass, and not the change in PON1 arylesterase, was inversely correlated with the change in left ventricular volume (ml/m2.7) (p = 0.0146 and 0.0114 for diastolic and systolic, respectively) and with the change in hemoglobin (p = 0.0042).Conclusion: Both PON1 mass and arylesterase activity are increased by kidney transplantation. The increase in PON1 mass is consistent with a novel relationship to the increase in hemoglobin and decrease in left ventricular volume and NT-proBNP seen when kidney function is restored.
Highlights
Patients with chronic kidney disease (CKD) are at increased risk for cardiovascular disease, including non-atherosclerotic disease characterized by left ventricular hypertrophy (LVH) [1]
The kidney transplant (KT) group consisted of HD or peritoneal dialysis (PD) patients expected to receive a living donor KT within 2 months; the dialysis group consisted of patients without identified living donors and not expected to receive a transplant for the 24 months
KT resulted in significant increases in hemoglobin concentration for both HD and PD patients, but KT significantly increased albumin concentration only in the PD patients
Summary
Patients with chronic kidney disease (CKD) are at increased risk for cardiovascular disease, including non-atherosclerotic disease characterized by left ventricular hypertrophy (LVH) [1]. Among the noninvasive tools used to measure left ventricular (LV) volume and mass, cardiac magnetic resonance imaging (CMR) is useful due to its accuracy and precision. LV changes by CMR can be correlated with cardiovascular biomarkers such as adiponectin [2]. Since CMR is a useful tool to correlate cardiovascular biomarker changes with both changes in kidney function after KT and measurable changes in cardiac function, we extended our study to paraoxonase 1 (PON1). Restored kidney function through transplantation reduces left ventricular volume in both systole and diastole. We report the association of changes in PON1 with changes in left ventricular volume and left ventricular mass after kidney transplantation
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call