Influence of renal transplantation upon uraemic cardiomyopathy in chronically dialysed patients with end-stage renal failure
Med Sci Monit 1998; 4(3): CR484-490
Comparative echocardiographic examinations of 6 patients with a preserved arteriovenous fistula revealed that one year after renal transplantation these subjects demonstrated lower values of IVS, LVPW and LVMI, as well as a better lv systolic function (EF) and diastolic function (VmaxE/VmaxA, Earea/Aarea) when compared with the patients still undergoing chronic dialyses (cd). The comparison of parameters obtained during echocardiographic investigations performed in 6 patients one year after renal transplantation with the examinations of the same people before renal transplantation also proved that there was a decrease in cardiac muscle hypertrophy, an improvement of lv systolic function and a significant betterment of lv diastolic function (1/3[E+A] area, the part of 1/3[E+A]area in the total [E+A]area) after a successful renal transplantation. On the other hand, the examinations carried out in 42 cd patients in a one-year interval allowed for the conclusion that there was a tendency towards the increase of lv walls and lv mass hypertrophy (IVSd, LVPWd, LVM, LVMI) as well as towards the deterioration of lv systolic function (EF, mVcf) throughout a year. Thus, renal transplantation results in the regression of certain heart changes typical for uraemic cardiomyopathy in patients undergoing chronic dialyses before renal transplantation. Therefore, cardiac changes in patients suffering from end-stage renal failure are related to the nature of the dialysis treatment itself and to the presence of uraemic toxaemia.
Keywords: end-stage renal failure, Dialysis, uraemic cardiomyopathy, renal transplantation, left ventricle systolic and diastolic function