title: Left ventricular mass changes after renal transplantation: influence of dietary sodium and change in serum uric acid.
abstract: BACKGROUND
  We hypothesized that dietary sodium may modulate the effect of systolic blood pressure and other nonhemodynamic factors, such as high uric acid and renal dysfunction, on changes in the left ventricular mass after renal transplantation. The objective of the present 3-year follow-up longitudinal study was to assess the concomitant influence of these factors on changes in the left ventricular mass after renal transplantation.
  
  
  METHODS
  Twenty-four-hour urinary sodium excretion, glomerular filtration rate (isotopic clearance), and left ventricular mass (echocardiography) assessment were done in 165 renal transplant patients during the first year and after a follow-up of 3 years after renal transplantation.
  
  
  RESULTS
  At follow-up, therapy of hypertension was associated with normalization of blood pressure in 64% and a decrease in the prevalence of left ventricular hypertrophy from 66% to 56%. At baseline and follow-up, systolic blood pressure, sodium intake, and serum uric acid emerged as independent and significant determinants of the final left ventricular mass index. When the population was divided according to sex-specific tertiles of the final 24-hr urinary sodium excretion, the relationship between change in serum uric acid during follow-up, final left ventricular mass index, and final glomerular filtration rate was significant only on the highest tertile of 24-hr urinary sodium excretion.
  
  
  CONCLUSIONS
  The decrease in the prevalence of left ventricular hypertrophy after renal transplantation is blunted by high sodium intake. Persistence of the left ventricular hypertrophy may result from the combined adverse influences of excessive dietary sodium intake and increased serum uric acid during follow-up despite pharmacological control of blood pressure.
authors.affiliation: 1Department of Internal Medicine, Hospital Lapeyronie, CHU Montpellier, France. 2Department of Nephrology, Hospital Lapeyronie, CHU Montpellier, France. 3Address correspondence to: Docteur Guilhem du Cailar, MD, Departments of Internal Medicine and Nephrology, Hospital Lapeyronie, 34295 Montpellier Cedex 5 France.
authors.forename: Guilhem
authors.initials: G
authors.lastname: du Cailar
authors.forename: Carole
authors.initials: C
authors.lastname: Oudot
authors.forename: Pierre
authors.initials: P
authors.lastname: Fesler
authors.forename: Albert
authors.initials: A
authors.lastname: Mimran
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bonnet
authors.forename: Vincent
authors.initials: V
authors.lastname: Pernin
authors.forename: Jean
authors.initials: J
authors.lastname: Ribstein
authors.forename: Georges
authors.initials: G
authors.lastname: Mourad
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D004039:Diet, Sodium-Restricted; D005260:Female; D005602:France; D005919:Glomerular Filtration Rate; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D016030:Kidney Transplantation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D017673:Sodium Chloride, Dietary / Q000009:adverse effects* / Q000652:urine; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D017673:Sodium Chloride, Dietary; D014527:Uric Acid