[The comparison of selected parameters of structure and function of the cardiovascular system in patients with functioning graft on maintenance hemodialysis during a one year period].
Successful renal transplantation allows to correct most of the abnormalities that lead to cardiovascular system injury in chronic uremia. The aim of the present study was to analyze selected anatomical and functional parameters of the heart using echocardiography. The study was conducted prospectively in two groups of patients: 73 subjects with functioning graft and 53 patients on maintenance hemodialysis. Obtained results were compared between those two groups at the start of the study and later on after 6 and 12 months of follow-up. Post-transplant patients were included into the study 11 +/- 6.4 months after successful transplantation. Mean dialysis period prior to transplantation was 35 +/- 21 months. Patients in the control group were dialyzed for mean 54 +/- 25 months. The prevalence of various diseases of the cardiovascular system was equal in both groups of patients (most frequently diagnosed was hypertension). There was no difference in ejection fraction within groups during the whole study period, however the value of this parameter was higher among patients with functioning graft at the beginning of the study (p < 0.01) as well as after 6 and 12 months (p < 0.001) as compared to patients on dialysis. The prevalence of different morphological abnormalities of the heart, such as concentric hypertrophy, left ventricle dilatation, valve dysfunction as well as calcification of various structures, was equal in both groups of patients at the beginning of the study. In 87.7% of patients with functioning graft, left ventricle hypertrophy was diagnosed at the beginning of the study (mean LVMI value 176.9 +/- 55.5 g/m2) and this percentage decreased to 63% after 6 months (LVMI 155.8 +/- 60.3 g/m2; p < 0.001 vs. baseline) and 53.4% after 12 months (LVMI 141.6 +/- 62.1 g/m2; p < 0.001 vs. baseline). Regression of initial left ventricle hypertrophy, although less pronounced was also present among patients on maintenance dialysis. There was no difference in LVMI value between the studied groups at the beginning of the study, whereas after 6 and 12 months of observation it became significantly lower in patients with functioning graft (155.8 +/- 60.3 vs. 179.5 +/- 50.9 g/m2; p < 0.01 and 141.6 +/- 62.1 vs. 176.2 +/- 50.5 g/m2; p < 0.001). Based on obtained results we conclude that successful renal transplantation promotes the normalization of a number of echocardiographic parameters, especially leads to regression of left ventricle hypertrophy. Renal transplantation seems to be an optimal method of treatment in patients with end-stage renal failure, considering structure and function of the cardiovascular system.
Króliczak
M
M
Katedra i Klinika Nefrologii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Stompór
T
T
Sułowicz
W
W
Ochmański
W
W
Królczyk
J
J
D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000473:pathology / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation; D007688:Kidneys, Artificial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors