title: Differences in cardiac structure assessed by echocardiography between renal transplant recipients and chronic kidney disease patients.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is the leading cause of death in predialysis chronic kidney disease (CKD) and dialysis patients as well as in renal transplant recipients (RTRs). Left ventricular hypertrophy (LVH) starts early during the course of CKD and is a strong predictor of CVD in this population. Regression of LVH after a successful renal transplantation remains a debatable issue among investigators, whereas there is little data comparing echocardiographic measurements between patients with predialysis CKD and RTRs.
  
  
  OBJECTIVE
  The aim of this study was to compare echocardiographic measurements of LV structure and function between predialysis CKD patients and RTRs of similar renal function level.
  
  
  METHODS
  We conducted a case control study with individual (1:2) matching from the Renal Transplant and the predialysis CKD Outpatient Clinic. For each of the 36 RTRs, two matched for gender, age and estimated glomerular filtration rate (eGFR) predialysis CKD outpatients (72 patients) were included. All patients underwent transthoracic echocardiography and LV mass, LV mass index [LVM and LVMI = LVM/BSA g/m(2)] and indices of systolic function were measured. In a subgroup of 12 RTRs we retrospectively assessed and compared the LVMI measurements at three different time points, during predialysis, dialysis and post transplant period.
  
  
  RESULTS
  The prevalence of LVH was 33% in RTRs and 52% in CKD patients (ns). RTRs had significantly lower LVM and LVMI levels compared with predialysis CKD patients (P = .006 and P = .008) while the other echocardiographic indices did not differ. In the subgroup of 12 RTRs, post-transplant LVMI levels (105 ± 25 g/m(2)) were significantly lower in comparison with predialysis (147 ± 57 g/m(2)) and dialysis LVMI levels (169 ± 72 g/m(2)) (P = .01, P = .01, respectively).
  
  
  CONCLUSIONS
  RTRs had significantly lower LVMI compared with predialysis CKD patients of similar age, renal function, hemoglobin and blood pressure level.
authors.affiliation: Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Dounousi
authors.affiliation: Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Mitsis
authors.affiliation: Cardiology Department, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: K K
authors.initials: KK
authors.lastname: Naka
authors.affiliation: Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Pappas
authors.affiliation: Cardiology Department, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: L
authors.initials: L
authors.lastname: Lakkas
authors.affiliation: Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Harisis
authors.affiliation: Cardiology Department, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Pappas
authors.affiliation: Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Koutlas
authors.affiliation: Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Tzalavra
authors.affiliation: Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Spanos
authors.affiliation: Cardiology Department, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: L K
authors.initials: LK
authors.lastname: Michalis
authors.affiliation: Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece. Electronic address: ksiamop@cc.uoi.gr.
authors.forename: K C
authors.initials: KC
authors.lastname: Siamopoulos
mesh_terms: D004452:Echocardiography; D005260:Female; D006115:Greece / Q000453:epidemiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D012189:Retrospective Studies; D066027:Transplant Recipients; D016277:Ventricular Function, Left / Q000502:physiology*