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Article Type

Original Study

Abstract

Aim The aim of this study was to investigate the effects of renal transplantation on cardiac function and morphology in patients with ESRD on regular hemodialysis at the post-transplant period. Background End stage renal disease (ESRD) is considered an overall general health issue related to increased morbidity & mortality. The mortality rate among cases with ESRD who have been experiencing dialysis has been approximately seven times higher than for comparable cases in the general population and has been to a great extent related to cardiovascular causes. Cardiac diseases have been common in cases with chronic kidney disease (CKD). About 75% of cases with CKD who begin dialysis have left ventricular hypertrophy, left ventricle dilatation or diminished left ventricle functional shortening; these cardiac anomalies keep on progressing during the first year of hemodialysis. Besides these changes, impairment of diastolic function has been also expected in these cases. For example, Left ventricular hypertrophy has been a very common pathological condition in cases with ESRD and considered as an independent risk variable for death and cardiac disease. Generally, many risk variables including uremic toxins, fluid retention & chronic volume over-load, anemia, hypoalbuminemia, hyperparathyroidism, arterio-venous fistula and pressure over-load were involved in the pathogenesis for Left Ventricular Hypertrophy in cases with ESRD. Renal transplantation is a well-established treatment for ESRD, allowing most patients to return to a satisfactory quality of life. It is the most acceptable treatment modality for the patients with ESRD, which improves some complications of renal failure such as chronic uremia and volume overload. Methods This cross sectional study was done on 40 kidney transplant recipients enrolled from the patients in the NIUN according to the inclusion and exclusion criteria. We compared echocardiographic findings and some cardiac risk factors after transplantation with those done before transplantation. Results There was highly significant reduction with respect to serum creatinine, blood urea, phosphorus. Comparison of echocardiographic findings between the pre-transplant period and post-transplant period. Ejection fraction (EF) was significantly increased at the post-transplant period while left ventricular systolic dimension (LVSD), left ventricular diastolic dimension (LVDD), and LVH showed a significant decrease after transplantation. Conclusions We have found that cardiac parameters showed significant improvement after transplantation as well as cardiac risk factors including anemia, hyperparathyroidism and volume & pressure overload.

Keywords

Cardiac outcomes, kidney transplantation, echocardiography

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