Association and prognostic impact of persistent left ventricular hypertrophy after live-donor kidney transplantation: a prospective study.
OBJECTIVE
Persistent or de novo left ventricular hypertrophy (LVH) is a risk factor for cardiovascular diseases and congestive heart failure following renal transplantation (RT). Our aim was to determine the associations and impact of persistent LVH on RT outcome.


METHODS
We included 72 live-donor renal allograft recipients with mean age of 28.5 years who had evidence of LVH at time of transplantation and had stable functioning grafts 1 year after transplantation. Cardiac status of all recipients was assessed before transplantation and at 1 year after transplantation by echocardiography. Recipients were subdivided into two groups according to persistence or regression of LVH 1 year after transplantation. The first group included 33 patients who had persistent LVH. The second group included 39 patients in whom LVH had regressed (control group). Both groups were closely followed for 10 years.


RESULTS
Univariate analysis showed that persistent LVH 1 year after RT was significantly associated with high serum creatinine, higher incidence of medical infection, and acute and chronic rejection. Chronic rejection and infection were the only valid associations on multivariate logistic regression analysis. Patient and graft survival were significantly lower in the persistent LVH group (P = 0.012).


CONCLUSIONS
Persistent LVH may be associated with higher incidence of medical infection and chronic rejection that worsen the prognosis for renal transplant recipients.
Sheashaa
Hussein Attia
HA
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. drhattia@yahoo.com
Abbas
Tarek M
TM
Hassan
Nabil A
NA
Mahmoud
Khaled M
KM
El-Agroudy
Amgad E
AE
Sobh
Mohamed A
MA
Ghoneim
Mohamed A
MA
D000328:Adult; D003404:Creatinine / Q000097:blood; D004452:Echocardiography; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications*; D007239:Infections / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D011446:Prospective Studies
D003404:Creatinine