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Sun L, Zhang D, Liu J, Gao X, Suo C, Fei S, Huang Z, Wang Z, Chen H, Tao J, Han Z, Ju X, Wang Z, Gu M, Tan R. Left ventricular remodeling and its association with mineral and bone disorder in kidney transplant recipients. Ren Fail 2024; 46:2300303. [PMID: 38263697 PMCID: PMC10810624 DOI: 10.1080/0886022x.2023.2300303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/23/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The assessment of left ventricular (LV) remodeling and its association with mineral and bone disorder (MBD) in kidney transplant recipients (KTRs) have not been systematically studied. We aimed to evaluate LV remodeling changes one year after kidney transplantation (KT) and identify their influencing factors. METHODS Ninety-five KTRs (68 males; ages 40.2 ± 10.8 years) were followed before and one year after KT. Traditional risk factors and bone metabolism indicators were assessed. Left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF) and left ventricular diastolic dysfunction (LVDD) were measured using two-dimensional transthoracic echocardiography. The relationship between MBD and LV remodeling and the factors influencing LV remodeling were analyzed. RESULTS One year after KT, MBD was partially improved, mainly characterized by hypercalcemia, hypophosphatemia, hyperparathyroidism, 25-(OH) vitamin D deficiency, elevated bone turnover markers, and bone loss. LVMI, the prevalence of left ventricular hypertrophy (LVH), and the prevalence of LVDD decreased, while LVEF increased. LVH was positively associated with postoperative intact parathyroid hormone (iPTH) and iPTH nonnormalization. △LVMI was positively associated with preoperative type-I collagen N-terminal peptide and postoperative iPTH. LVEF was negatively associated with postoperative phosphorous. △LVEF was negatively associated with postoperative iPTH. LVDD was positively associated with postoperative lumbar spine osteoporosis. Preoperative LVMI was negatively associated with △LVMI and positively associated with △LVEF. Advanced age, increased BMI, diabetes, longer dialysis time, lower albumin level, and higher total cholesterol and low-density lipoprotein levels were associated with LV remodeling. CONCLUSIONS LV remodeling partially improved after KT, showing a close relationship with MBD.
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Affiliation(s)
- Li Sun
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Dongliang Zhang
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiawen Liu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiang Gao
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chuanjian Suo
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shuang Fei
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhengkai Huang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zijie Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Chen
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jun Tao
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhijian Han
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaobing Ju
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zengjun Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Min Gu
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ruoyun Tan
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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de Verteuil I, Fitzpatrick J, Alvarez Elias AC, Banh T, Vasilevska-Ristovska J, Browne J, Bondi BC, Hui W, Slorach C, Wei Teoh C, Langlois V, Mertens L, Parekh RS. Longitudinal Changes in Cardiac Structure and Function in Pediatric Kidney Transplant Recipients. Hypertension 2022; 79:1680-1689. [PMID: 35652352 DOI: 10.1161/hypertensionaha.121.17483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Cardiovascular disease results in increased morbidity and mortality in pediatric kidney transplant recipients. Longitudinal changes in cardiac structure and function and the association with blood pressure control over time in pediatric kidney transplant recipients are unknown. METHODS To determine the influence of blood pressure control on cardiac changes following pediatric kidney transplant, we conducted a retrospective cohort study of children who received their first kidney transplant at the Hospital for Sick Children from 2004 to 2015. Children were followed until transfer to adult care or censoring in July 2018. Cardiac structure and function parameters were collected from clinical echocardiograms and assessed using standardized scores. Blood pressure control was determined by systolic blood pressure Z scores (above or below the 90th percentile) in combination with antihypertensive medications. A segmented mixed-effects model assessed Z scores of interventricular septum thickness, left ventricular end-diastolic dimension, and left ventricular posterior wall dimension. RESULTS Of 142 children included, 58% were men, mean age at transplant was 11 (±4.5) years, and average follow-up time was 4 (±3) years. All cardiac structural Z scores improved during follow-up. Interventricular septum thickness normalized at 4.0 years post-transplant. Left ventricular end-diastolic dimension normalized at 1.5 years post-transplant. Left ventricular posterior wall dimension normalized at 6.3 years post-transplant. Left ventricular mass index showed sustained improvement up to 12 years post-transplant. Individuals with uncontrolled blood pressure had increased left ventricular mass (β=2.97 [95% CI, 0.77-5.16]). CONCLUSIONS Cardiac structural abnormalities improve following kidney transplantation and normalize within 7 years, especially with controlled blood pressure. Strict blood pressure control is critical after pediatric kidney transplantation.
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Affiliation(s)
- Isabel de Verteuil
- Child Health Evaluative Sciences, Research Institute (I.d.V., J.F., T.B., J.V.-R., J.B., B.C.B., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jessica Fitzpatrick
- Child Health Evaluative Sciences, Research Institute (I.d.V., J.F., T.B., J.V.-R., J.B., B.C.B., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ana Catalina Alvarez Elias
- Division of Nephrology, (A.C.A.E., C.W.T., V.L., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy Management and Evaluation (A.C.A.E.), Toronto, Ontario, Canada
| | - Tonny Banh
- Child Health Evaluative Sciences, Research Institute (I.d.V., J.F., T.B., J.V.-R., J.B., B.C.B., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jovanka Vasilevska-Ristovska
- Child Health Evaluative Sciences, Research Institute (I.d.V., J.F., T.B., J.V.-R., J.B., B.C.B., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jordan Browne
- Child Health Evaluative Sciences, Research Institute (I.d.V., J.F., T.B., J.V.-R., J.B., B.C.B., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bianca C Bondi
- Child Health Evaluative Sciences, Research Institute (I.d.V., J.F., T.B., J.V.-R., J.B., B.C.B., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Wei Hui
- Labatt Family Heart Center (W.H., C.S., L.M.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Cameron Slorach
- Labatt Family Heart Center (W.H., C.S., L.M.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Chia Wei Teoh
- Division of Nephrology, (A.C.A.E., C.W.T., V.L., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada.,Temerty School of Medicine (C.W.T., V.L., L.M., R.S.P.), Toronto, Ontario, Canada
| | - Valerie Langlois
- Division of Nephrology, (A.C.A.E., C.W.T., V.L., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada.,Temerty School of Medicine (C.W.T., V.L., L.M., R.S.P.), Toronto, Ontario, Canada
| | - Luc Mertens
- Labatt Family Heart Center (W.H., C.S., L.M.), The Hospital for Sick Children, Toronto, Ontario, Canada.,Temerty School of Medicine (C.W.T., V.L., L.M., R.S.P.), Toronto, Ontario, Canada
| | - Rulan S Parekh
- Child Health Evaluative Sciences, Research Institute (I.d.V., J.F., T.B., J.V.-R., J.B., B.C.B., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada.,Division of Nephrology, (A.C.A.E., C.W.T., V.L., R.S.P.), The Hospital for Sick Children, Toronto, Ontario, Canada.,Temerty School of Medicine (C.W.T., V.L., L.M., R.S.P.), Toronto, Ontario, Canada.,Toronto, Ontario, Canada and Dalla Lana School of Public Health (R.S.P.), Toronto, Ontario, Canada.,University of Toronto. University Health Network (R.S.P.) Toronto, Ontario, Canada
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Sertić Z, Letilović T, Kanižaj TF, Knotek M, Hadžibegović I, Starovečki I, Jerkić H. Cardiovascular mortality in liver and kidney transplant recipients: A retrospective analysis from a single institution. Medicine (Baltimore) 2021; 100:e26019. [PMID: 34011105 PMCID: PMC8137067 DOI: 10.1097/md.0000000000026019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/30/2021] [Indexed: 01/05/2023] Open
Abstract
Previous studies have demonstrated cardiovascular causes to be among the leading causes of death after liver (LT) and kidney transplantation (KT). Although both recipient populations have unique pre-transplant cardiovascular burdens, they share similarities in post-transplant exposure to cardiovascular risk factors. The aim of this study was to compare cardiovascular mortality after LT and KT.We analyzed causes of death in 370 consecutive LT and 207 KT recipients from in-hospital records at a single tertiary transplant center. Cardiovascular causes of death were defined as cardiac arrest, heart failure, pulmonary embolism, or myocardial infarction.After a median follow-up of 36.5 months, infection was the most common cause of death in both cohorts, followed by cardiovascular causes in KT recipients and graft-related causes in LT recipients in whom cardiovascular causes were the third most common. Cumulative incidence curves for cardiovascular mortality computed with death from other causes as the competing risk were not significantly different (P = .36). While 1-year cumulative cardiovascular mortality was similar (1.6% after LT and 1.5% after KT), the estimated 4-year probability was higher post-KT (3.8% vs. 1.6%). Significant pre-transplant risk factors for overall mortality after KT in multivariable analysis were age at transplantation, left ventricular ejection fraction <50%, and diastolic dysfunction grade 2 or greater, while significant risk factors for cardiovascular mortality were peripheral artery disease and left ventricular ejection fraction <50%. In the LT group no variables remained significant in a multivariable model for either overall or cardiovascular mortality.The present study found no significant overall difference in cardiovascular mortality after LT and KT. While LT and KT recipients may have similar early cardiovascular mortality, long-term risk is potentially lower after LT. Differing characteristics of cardiovascular death between these two patient populations should be further investigated.
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Affiliation(s)
- Zrinka Sertić
- Department of Emergency Medicine, University Hospital Centre Zagreb
| | - Tomislav Letilović
- Division of Cardiology, University Hospital Merkur
- School of Medicine, University of Zagreb
| | - Tajana Filipec Kanižaj
- School of Medicine, University of Zagreb
- Division of Gastroenterology, University Hospital Merkur, Zagreb, Croatia
| | | | - Irzal Hadžibegović
- Division of Cardiology, University Hospital Dubrava, Zagreb
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | | | - Helena Jerkić
- Division of Cardiology, University Hospital Merkur
- School of Medicine, University of Zagreb
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Abreo K, Sachdeva B, Abreo AP. To ligate or not to ligate hemodialysis arteriovenous fistulas in kidney transplant patients. J Vasc Access 2020; 22:942-946. [PMID: 33176556 DOI: 10.1177/1129729820970786] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
There is significant disagreement about maintenance or ligation of arteriovenous fistulas (AVFs) in kidney transplant patients (KTPs). Potential harms from maintaining AVFs are their impact on cardiac function, cosmetic concerns and complications such as bleeding and rupture. High flow AVFs can place a strain on the heart and cause or exacerbate pre-existing cardiac dysfunction. There is an improvement in cardiac function after kidney transplantation independent of vascular access status. Studies comparing cardiac parameters in patients with and without AVFs after renal transplantation have shown conflicting results. Ligation of high flow AVFs in KTPs resulted in improvement in cardiac function and prevention of heart failure. In KTPs with deteriorating renal function and high flow AVFs, banding of the AVFs to reduce flow is an option. Patients who retain AVFs after renal transplant have the advantage of immediate, optimal access should the transplant fail and may have preserved kidney function. The patient's post-transplant kidney function, risk factors for transplant loss, AVF blood flow, and cardiac function play an important role when making the decision to ligate or preserve AVFs.
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Affiliation(s)
- Kenneth Abreo
- LSU Health Shreveport School of Medicine, Shreveport, LA, USA
| | - Bharat Sachdeva
- LSU Health Shreveport School of Medicine, Shreveport, LA, USA
| | - Adrian P Abreo
- LSU Health Shreveport School of Medicine, Shreveport, LA, USA
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Lakkas L, Naka KK, Bechlioulis A, Girdis I, Duni A, Koutlas V, Moustakli M, Katsouras CS, Dounousi E, Michalis LK. The prognostic role of myocardial strain indices and dipyridamole stress test in renal transplantation patients. Echocardiography 2019; 37:62-70. [PMID: 31872917 DOI: 10.1111/echo.14570] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/16/2019] [Accepted: 12/04/2019] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Renal transplantation (RT) increases survival in end-stage kidney disease patients but cardiovascular diseases remain the leading cause of morbidity and mortality. We evaluated the role of myocardial strain (2DSTE) indices and dipyridamole-induced (DIPSE) changes in echocardiographic parameters at baseline for the prediction of clinical events and echocardiographically assessed deterioration of cardiac function in a RT population. METHODS Forty-five RT patients underwent an echocardiographic study at baseline including 2DSTE and DIPSE. If no cardiovascular/renal event occurred, patients were investigated at 3-year follow-up; eight patients presented a clinical event while 37 patients were re-evaluated. RESULTS Coronary flow reserve (CFR) was abnormal in 24% of the population. DIPSE induced improvements in classic and 2DSTE systolic and diastolic echocardiographic indices including TWIST, UNTWIST, global longitudinal strain (GLS), and circumferential strain (P < .05 for all). Compared to baseline, deteriorations in E/E', LVEF, E', and TWIST were observed at follow-up (P < .05 for all). DIPSE-induced changes in GLS, global radial strain, and LVEF were associated with changes in these indices at follow-up (P < .05 for all). Higher LV mass index, E/E', and lower MAPSE, E', and CFR at baseline were associated with the occurrence of clinical events at follow-up (P < .05 for all). CONCLUSIONS In RT patients, coronary vascular dysfunction (ie, low CFR) was associated with the occurrence of adverse events. DIPSE-induced changes in myocardial strain and classic echocardiographic indices could identify individuals with a subclinical deterioration in cardiac function at follow-up. This may indicate that DIPSE could serve as a means to assess myocardial reserve in this population.
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Affiliation(s)
- Lampros Lakkas
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Katerina K Naka
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Aris Bechlioulis
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Ioannis Girdis
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Anila Duni
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece
| | - Vasileios Koutlas
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece
| | - Maria Moustakli
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Christos S Katsouras
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Evangelia Dounousi
- Renal Transplant Unit, University Hospital of Ioannina, Ioannina, Greece
| | - Lampros K Michalis
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
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Omrani H, Rai A, Daraei Z, Sadeghi M. Study of Echocardiographic Changes After Kidney Transplantation in End-stage Renal Disease Patients. Med Arch 2018; 71:408-411. [PMID: 29416201 PMCID: PMC5788512 DOI: 10.5455/medarh.2017.71.408-411] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Cardiovascular complications are the leading cause of mortality in end-stage renal disease (ESRD) patients. This study aimed to evaluate the efficacy of kidney transplantation on the cardiovascular status in ESRD patients. Methods During 2012 to 2014 and in a cross-sectional study, 181 patients were randomly selected for this study. All patients were followed for periods of 6 and 12 months after kidney transplantation. The patients with ESRD and kidney transplant recipients; the patients with left ventricle ejection fraction<50%, left ventricular hypertrophy, mitral valve regurgitation and tricuspid valve regurgitation were included to study and the patients with kidney transplant rejection, myocardial infarction, high blood pressure with treatment-resistant, high blood pressure and addicted patients were censored. Results one hundred and eighty-one patients had the mean age of 38.52 (range, 16-69 years) that 54.7% were men and the mean duration of dialysis was 3.74 years. There were significant differences after 6 and 12 months compared with before and also 6 months compared with 12 months from kidney transplantation for all echocardiographic findings. The echocardiographic findings improved after 12 months compared with 6 months and also these times compared with before kidney transplantation. Conclusions The results of this study appeared that kidney transplantation had a positive effect on the cardiovascular status of patients with ESRD and improved the cardiac function of these patients.
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Affiliation(s)
- Hamidreza Omrani
- Nephrology and Urology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Rai
- Department of Cardiology, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Daraei
- Nephrology and Urology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Liu F, Sun Y, Xu T, Sun L, Liu L, Sun W, Feng X, Ma J, Wang L, Yao L. Effect of Nocturnal Hemodialysis versus Conventional Hemodialysis on End-Stage Renal Disease: A Meta-Analysis and Systematic Review. PLoS One 2017; 12:e0169203. [PMID: 28107451 PMCID: PMC5249197 DOI: 10.1371/journal.pone.0169203] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 12/12/2016] [Indexed: 12/20/2022] Open
Abstract
Objectives The purpose of this study is to assess the efficacy and safety of nocturnal hemodialysis on end-stage renal disease (ESRD) patients. Methods We searched Medline, EmBase, and the Cochrance Central Register of Controlled Trials for studies up to January 2016. Analysis was done to compare variant outcomes of different hemodialysis schedules, including mortality, cardiovascular-associated variables, uremia-associated variables, quality of life (QOL), side-effects, and drug usage. Results We collected and analyzed the results of 28 studies involving 22,508 patients in our meta-analysis. The mortality results in this meta-analysis indicated that the nocturnal hemodialysis (NHD) group was not significantly different from conventional hemodialysis (CHD) group (Mortality: OR: 0.75; 95% confidence intervals (CIs): 0.52 to 1.10; p = 0.145), but the CHD group had significantly fewer number of hospitalizations than the NHD group (OR: 1.54; 95%CI: 1.32 to 1.79; p<0.001). NHD was superior to CHD for cardiovascular-associated (left ventricular hypertrophy [LVH]: SMD: -0.39; 95%CI: -0.68 to -0.10; p = 0.009, left ventricular hypertrophy index [LVHI]: SMD: -0.64; 95%CI: -0.83 to -0.46; p<0.001) and uremia-associated intervention results (Serum albumin: SMD: 0.89; 95%CI: 0.41 to 1.36; p<0.001). For the assessment of quality of life, NHD treatment significantly improved the patients’ QOL only for SF36-Physical Components Summary (SMD: 0.43; 95%CI: 0.26 to 0.60; p<0.001). NHD intervention was relatively better than CHD for anti-hypertensive drug usage (SMD: -0.48; 95%CI: -0.91 to -0.05; p = 0.005), and there was no difference between groups in our side-effects assessment. Conclusion NHD and CHD performed similarly in terms of ESRD patients’ mortality and side-effects. NHD was superior to CHD for cardiovascular-associated and uremia-associated results, QOL, and drug usage; for number of hospitalizations, CHD was relatively better than NHD.
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Affiliation(s)
- Fangjie Liu
- Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yiting Sun
- Department of Clinical Medicine, China Medical University, Shenyang, Liaoning, China
| | - Tianhua Xu
- Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Li Sun
- Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Linlin Liu
- Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Wei Sun
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xin Feng
- Blood Purification Center, Liaoning Electric Power Center Hospital, Shenyang, Liaoning, China
| | - Jianfei Ma
- Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lining Wang
- Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Li Yao
- Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China
- * E-mail:
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Calleja AM, Rakowski H, Williams LK, Jamorski M, Chan CT, Carasso S. Left atrial and ventricular systolic and diastolic myocardial mechanics in patients with end-stage renal disease. Echocardiography 2016; 33:1495-1503. [DOI: 10.1111/echo.13284] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Anna M. Calleja
- Division of Cardiology; Department of Medicine; Toronto General Hospital; University of Toronto; Toronto ON Canada
| | - Harry Rakowski
- Division of Cardiology; Department of Medicine; Toronto General Hospital; University of Toronto; Toronto ON Canada
| | - Lynne K. Williams
- Department of Cardiology; Papworth Hospital NHS Foundation Trust; Cambridge United Kingdom
| | - Michal Jamorski
- Division of Cardiology; Department of Medicine; Toronto General Hospital; University of Toronto; Toronto ON Canada
| | - Christopher T. Chan
- Division of Nephrology; Department of Medicine; Toronto General Hospital; University of Toronto; Toronto ON Canada
| | - Shemy Carasso
- Non-invasive Cardiac Imaging B Padeh Medical Center; Poriya Israel
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Prevalence of Left Ventricular Hypertrophy and Left Ventricular Dysfunction in Older Renal Transplant Recipients. Transplant Proc 2016; 48:1641-3. [DOI: 10.1016/j.transproceed.2016.02.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/09/2016] [Accepted: 02/24/2016] [Indexed: 02/04/2023]
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Noninvasive perioperative monitoring of arterial function in patients with kidney transplantation. Transplant Proc 2014; 45:3682-4. [PMID: 24314996 DOI: 10.1016/j.transproceed.2013.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Development of atherosclerosis is accelerated in kidney transplant recipients. Impaired metabolic pathways have a complex effect on the arterial wall, which can be measured by noninvasive techniques. Few data are available on the change of stiffness parameters in the postoperative course, so in this study we analyzed the stiffness parameters of kidney transplant recipients during the perioperative period. Seventeen successful primary kidney transplant patients with uneventful postoperative period (7 woman, 10 men; 46.16 ± 12.19 years) were involved in our short-term prospective longitudinal study. We analyzed the correlation between noninvasively assessed stiffness parameters (pulse wave velocity [PWV], augmentation index [AIx], pulse pressure [PP], systolic area index, diastolic area index, diastolic reflection area), ankle-brachial index (ABI), and laboratory parameters (creatinine, glomerular filtration rate, urea, haemoglobin, C-reactive protein). Stiffness parameters were measured with a Tensiomed Arteriograph. These parameters were assessed before the transplantation, and 24 hours, and 1 and 2 weeks after surgery under standard conditions. We found that creatinine (P = .0008) and C-reactive protein (P = .006) serum levels decreased, and glomerular filtration rate increased significantly (P = .0005). We revealed that PWV (P = .0075) and AIx (P = .013) improved significantly. There was no significant change in ABI, PP, and the other monitored parameters. Along with the available data in the literature, our findings suggest that kidney transplantation has a positive effect on the arterial function.
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