Significant benefits after renal transplantation in patients with chronic heart failure and chronic kidney disease

Kute, Vivek B.; Vanikar, Aruna V; Patel, Himanshu V.; Gumber, Manoj R.; Shah, Pankaj; Balwani, Manish R; Gautam, Rajesh; Modi, Pranjal; Shah, Veena R; Trivedi, Hargovind L

doi:10.3109/0886022x.2014.899474

Cited by 13 publications

(7 citation statements)

References 18 publications

(20 reference statements)

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“…Similar experiences have been reported in other single institution studies [96][97][98]. Another single center experience reported that KT patients with baseline mean EF of 35% had similar outcomes to those with normal EF in terms of graft and patient survival, largely due to improvement in EF post-KT [99]. These data suggest that restoration of eGFR and reversal of the uremic milieu may play a role in restoration or improvement of myocardial mechanics and function in patients with preexisting cardiomyopathy.…”

Section: H E a R T F A I L U R E I N T H E K I D N E Y T R A N S P L A N T R E C I P I E N Tsupporting

confidence: 81%

Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies

Rangaswami

Mathew

Parasuraman

et al. 2019

Nephrology Dialysis Transplantation

142

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Section: H E a R T F A I L U R E I N T H E K I D N E Y T R A N S P L A N T R E C I P I E N Tsupporting

confidence: 81%

Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies

Rangaswami

Mathew

Parasuraman

et al. 2019

Nephrology Dialysis Transplantation

142

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“…We observed that both LV mass and LV dimensions improved following KTX, which is consistent with findings from existing literature on the subject. 23,29,30 As the increased afterload caused by hemodynamic abnormalities in ESKD improves following KTX, the heart begins to remodel. 31 This is what we in our cohort observed with the improvements to LV dimensions and decrease in LV mass.…”

Section: Discussionmentioning

confidence: 99%

The effect of kidney transplantation on left ventricular remodeling and global diastolic strain rate in end‐stage renal disease

et al. 2021

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Background: Diastolic dysfunction is an early marker of cardiac pathology in end-stage kidney disease (ESKD) patients. The ratio of transmitral filling velocity (E) to early diastolic strain rate (E/e'sr) is a novel non-invasive marker of early left ventricular (LV) filling pressure obtained using two-dimensional speckle tracking echocardiography (2DSTE).Methods: In a prospective cohort of kidney transplant (KTX) recipients with echocardiograms performed pre-transplant we obtained repeat echocardiograms at 6 months following transplant. All echocardiograms were analyzed using 2DSTE where E/e'sr and global longitudinal strain were obtained. Paired tests were used to assess changes to cardiac structure and function following KTX.Results: A total of 33 patients were included in the study (mean age was 46.6 ± 13.7 years and 42% were males). The primary causes of ESKD in the cohort were glomerular disease (33%), hypertension (30%), and polycystic kidney disease (12%). The median (IQR) time spent on dialysis was 5.4 years [2.9, 7.7 years]. A reverse remodeling of the LV was observed following KTX as LV mass decreased (189.2 ± 57.5 g vs 171.1 ± 56.8 g, P = 0.014). LV filling pressure decreased as assessed by E/e'sr (103.7 ± 51.1 cm vs 72.6 ± 35.5 cm, P = 0.009). E to early diastolic mitral annular tissue velocity (E/e') did not change following KTX (9.9 ± 4.5 vs 10.3 ± 4.1, P = 0.54). Additionally, both LV internal diastolic and systolic diameter decreased significantly. Conclusion:Reverse cardiac remodeling following KTX was observed as improvements in LV mass and LV dimensions. LV filling pressure improved as assessed by E/e'sr decreased following KTX, whereas E/e' did not change.

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confidence: 99%

“…2 However, several small observational studies have shown that, in certain subsets, kidney transplantation can lead to improvements in LV function and normalization of ejection fraction. [4][5][6][7][8][9] Stratifying cardiovascular risk for patients with left ventricular dysfunction remains a challenge that faces cardiologists and nephrologists alike. Protocols for cardiac evaluation vary from center to center‚ and this reflects heterogeneity in society guidelines.…”

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confidence: 99%

Cardiologist Evaluation and Approval Was the Primary Predictor of Kidney Transplant Candidacy and Transplantation Among Patients With Reduced Left Ventricular Ejection Fraction

Madden

Gallen

Newman

et al. 2023

Transplantation Direct

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P revalence of left ventricular systolic dysfunction in patients with end-stage kidney disease (ESKD) is high, with an estimated 16% to 18% of ESKD patients affected in the literature. Of these, 60% had presumed nonischemic cardiomyopathy as diagnosed by the absence of myocardial ischemia on perfusion imaging. 1,2 Left ventricular systolic dysfunction is an independent risk factor for all-cause mortality in ESKD patients. 1 The pathophysiology of left ventricular dysfunction in ESKD is thought to relate to the uremic milieu leading to alterations in cardiac structure and function. The risk of uremic cardiomyopathy increases with time spent on dialysis 2 ; data from Medicare billing estimated the incidence of new-onset heart failure (HF) at 12.0% and 32.3% of patients at 12 and 36 mo after listing for kidney transplant,

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Significant benefits after renal transplantation in patients with chronic heart failure and chronic kidney disease

Abstract: RTx may play a role in reversing LV systolic dysfunction. Once thought by many to be a contraindication for renal transplantation, this appears not to be the case. The outcomes between the 2 groups are comparable and transplant is an option for even low EF patients.

Cited by 13 publications

References 18 publications

Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies

Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies

The effect of kidney transplantation on left ventricular remodeling and global diastolic strain rate in end‐stage renal disease

Cardiologist Evaluation and Approval Was the Primary Predictor of Kidney Transplant Candidacy and Transplantation Among Patients With Reduced Left Ventricular Ejection Fraction

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