Suppr超能文献

肾移植受者心脏结构和功能的变化

Changes in Cardiac Structure and Function of Recipients after Kidney Transplantation.

作者信息

Akkaya Suleyman, Cakmak Umit

机构信息

Department of Cardiology, Health Sciences University, Gazi Yasargil Research and Training Hospital, Diyarbakir 21070, Turkey.

Department of Nephrology, Health Sciences University, Gazi Yasargil Research and Training Hospital, Diyarbakir 21070, Turkey.

出版信息

J Clin Med. 2024 Jun 20;13(12):3629. doi: 10.3390/jcm13123629.

Abstract

Chronic kidney disease (CKD) elevates the risk of cardiovascular disease (CVD) and mortality. Uremic cardiomyopathy, frequently observed in CKD and end-stage renal disease (ESRD), involves alterations in cardiac structure and function, which may reverse post-kidney transplantation, although data remain controversial. This study examines the relationship between graft function and changes in cardiac parameters pre- and post-transplantation in kidney transplant recipients. A total of 145 pediatric and adult recipients of living or deceased donor kidney transplants were enrolled at Gazi Yaşargil Training and Research Hospital. This cohort study utilized transthoracic echocardiographic (TTE) imaging pre-transplant and at least two years post-transplant. Echocardiographic parameters were analyzed using standard techniques. The mean age of the participants was 35 years, with 60% male. The average dialysis duration prior to transplantation was 27 months. Most recipients (83.4%) received kidneys from living donors. Left ventricular diastolic dysfunction increased significantly post-transplant ( < 0.05), while other cardiac dimensions and functions, such as ejection fraction and pulmonary artery pressure, showed no significant change ( > 0.05). Notably, diastolic dysfunction worsened in patients with dysfunctional grafts (GFR < 45), correlating with increased pulmonary artery pressure post-transplant. The rate of antihypertensive drug use and the prevalence of diabetes mellitus increased significantly post-transplant ( < 0.05). This study demonstrates that left ventricular diastolic dysfunction present before kidney transplantation continues to persist post-transplantation in patients with end-stage renal disease undergoing chronic kidney disease treatment. Furthermore, it shows an increased rate of pulmonary artery pressure and pericardial effusion in patients with dysfunctional grafts after transplantation. Further research is required to explore strategies to reverse uremic cardiomyopathy and reduce cardiovascular risk in these patients.

摘要

慢性肾脏病(CKD)会增加心血管疾病(CVD)风险和死亡率。尿毒症性心肌病在CKD和终末期肾病(ESRD)中经常出现,涉及心脏结构和功能的改变,尽管数据仍存在争议,但这些改变在肾移植后可能会逆转。本研究探讨肾移植受者移植前和移植后移植物功能与心脏参数变化之间的关系。共有145名接受活体或 deceased 供肾移植的儿童和成人受者在加齐·亚萨尔吉尔培训与研究医院入组。这项队列研究在移植前和移植后至少两年使用经胸超声心动图(TTE)成像。使用标准技术分析超声心动图参数。参与者的平均年龄为35岁,男性占60%。移植前的平均透析时间为27个月。大多数受者(83.4%)接受的是活体供肾。移植后左心室舒张功能障碍显著增加(<0.05),而其他心脏维度和功能,如射血分数和肺动脉压,无显著变化(>0.05)。值得注意的是,移植物功能不全(肾小球滤过率<45)的患者舒张功能障碍恶化,与移植后肺动脉压升高相关。移植后抗高血压药物使用率和糖尿病患病率显著增加(<0.05)。本研究表明,接受慢性肾脏病治疗的终末期肾病患者肾移植前存在的左心室舒张功能障碍在移植后持续存在。此外,研究显示移植后移植物功能不全的患者肺动脉压和心包积液发生率增加。需要进一步研究以探索逆转尿毒症性心肌病和降低这些患者心血管风险的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e27f/11204455/6d2ddd4f20bf/jcm-13-03629-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验