Beta
42158

Changes in left ventricular mass and functions in patients with chronic kidney disease following renal transplantation

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Internal Medicine

Advisors

Belal, Dawlat M. , Fayyadh, Tareq M. , Ammar, Walid A.

Authors

Hammad, Hani Abdel-Rahman Saeid

Accessioned

2017-07-12 06:40:59

Available

2017-07-12 06:40:59

type

M.D. Thesis

Abstract

Background and objectives: CKD is a major public health problem; patients withESRD are characterized by higher mortality than the general population. CKD is arisk factor for all-cause mortality and CVD, the latter is the major cause of death indialysis patients. Cardiac abnormalities in CKD include LVH, LVD, systolic anddiastolic dysfunction. RT has become standard of care for patients with ESRD andis associated with improvement of LVH, systolic and diastolic dysfunction and CVmortality. This work was designed to assess the effect of RT on parameters ofCVD.Methods: 20 CKD patients were fully assessed clinically, laboratory and by dopplerechocardiography before and 3 months after successful RT.Results: there is a high prevalence of LVH, whether indexed by BSA (90%), height(80%) or by height2.7 (75%) prior to RT that was decreased significantly 3 monthsafter RT and there was a statistically significant reduction in LVM; LVM/BSA (P =0.002), LVM/Height (P = 0.007) and LVM/Height2.7 (P = 0.008). Improvement inLVM was associated with a significant decrease in serum creatinine level (P <0.005) and increase in the Hb (P < 0.005) level, improvement of LVEDD (P =0.092), LVESD (P = 0.266), SWT (P = 0.04) and PWT (P = 0.07). There wassignificant positive correlation between pre transplantation LVMi and hypertension(r = 0.55, P = 0.012), hypertension control (r = - 0.67, P = 0.001), serum creatininelevel (r = 0.45, P = 0.04) and serum uric acid (r = 0.49, P = 0.028). There was asignificant positive correlation between posttransplantation LVM index andhypertension duration (r = 0.52, P = 0.019) and hypertension control (r = - 0.49, P= 0.028). There was a non-significant improvement in the parameters of systolicfunction. There was a statistically significant decrease in LA diameter (P =0.016).There was a positive correlation between pre transplantation diastolic dysfunctionand hypertension (r = 0.47, P = 0.036) and serum creatinine level (r = 0.5, P =0.023) and between post transplantation diastolic dysfunction and HTN duration (r= 0.51, P = 0.019) despite no change in diastolic function and there wasconsiderable improvement of pulmonary hypertension. (P = 0.052)Conclusion: RT is associated with improvement in almost all parameters of CVDincluding LVM, LAD and systolic functions.

Issued

1 Jan 2013

DOI

http://dx.doi.org/10.21473/iknito-space/36095

Details

Type

Thesis

Created At

31 Jan 2023