ESPN 50th Annual Meeting

ESPN 2017


 
Improvement of Cardiac Functions in Patients With Severe Cardiac Risk After Renal Transplantation
BEGÜM AVCI 1 ESRA BASKIN 1 KAAN GÜLLEROĞLU 1 İLKAY ERDOĞAN 2 ÖZLEM KAZANCI 1 GÖKHAN MORAY 3 MEHMET HABERAL 3

1- PEDIATRIC NEPHROLOGY, BASKENT UNIVERSITY, ANKARA, TURKEY
2- PEDIATRIC CARDIOLOGY, BASKENT UNIVERSITY, ANKARA, TURKEY
3- GENERAL SURGERY, BASKENT UNIVERSITY, ANKARA, TURKEY
 
Introduction:

 Patients with chronic kidney disease (CKD) are at increased risk for cardiovascular morbidity and mortality. CKD evokes structural and functional cardiac changes such as left ventricular hypertrophy (LVH), LV dilatation, LV systolic and diastolic dysfunction. Restoration of renal function after renal transplantation (RTX) disrupts the negative cardiorenal interplay and may reverse some of the cardiac changes seen with CKD. We presented the patients with high cardiovascular risk and the success of renal transplantation on the cardiac functions.

Material and methods:

 Eleven RTX patients who had severe cardiac risk were evaluated by echocardiography before and after renal RTX. Left ventricular diastolic diameter, sistolic diameter, ejection fraction (%) were assesed by echocardiographic standart parameters.

Results:

 Mean transplantation age was 149.81±43,2 months and mean follow-up period 26.0±16.09 months after transplantation of eleven patients (F/M:6/5). After RTX, serum creatinine level was 0,67±0,16 (0,5-1,06) mg/dl and glomerular filtration rate was 102,38±23,29 (51-126) ml/dk/1,73m² in the sixth month. There was a statistically significant improvement (p<0,01) in all cardiac parameters. Preoperative mean ejection fraction (EF) significantly increased after RTX within six months (37,45±9,77%, 66,45±8,39% respectively, p<0,01). Preoperative mean left ventricular diastolic diameter (LVDD) and mean sistolic diameter (SD) were significantly decreased, after RTX with in six months (52,58±8,58 vs 42,86±9.25 and 42,57±8,16, vs 27.05±8.24 respectively, p<0,01). There were 9 patients (81.8%) received  multipl antihypertensive treatment before transplantation. Only 2 patients needed  antihypertensive treatment after transplantation.

Conclusions:

 After RTX cardiac functions improve markedly and rapidly in ESRD patients with severe cardiac risk. RTX should be considered the treatment of choice for ESRD patients with systolic heart failure, because a longer duration of dialysis in these patients may result in progressive and ultimately irreversible myocardial dysfunction.