Contribution of Anemia and Hypertension to Left Ventricular Hypertrophy During the Initial 2 Years After Renal Transplantation

• Published in: Transplantation proceedings 2011-07, Vol.43 (6), p.2199-2204
• Main Authors: Ibernon, M, Moreso, F, Ruiz-Majoral, A, Sarrias, X, Sarrias, M, Grinyó, J.M, Serón, D
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anemia - blood; Anemia - diagnosis; Anemia - drug therapy; Anemia - etiology; Anemias. Hemoglobinopathies; Biological and medical sciences; Biomarkers - blood; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Diseases of red blood cells; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hematinics - therapeutic use; Hematologic and hematopoietic diseases; Hemoglobins - metabolism; Humans; Hypertension - diagnosis; Hypertension - etiology; Hypertension - physiopathology; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - etiology; Kidney Transplantation - adverse effects; Male; Medical sciences; Middle Aged; Proteinuria - etiology; Regression Analysis; Risk Assessment; Risk Factors; Spain; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Time Factors; Tissue, organ and graft immunology; Treatment Outcome; Ultrasonography; Young Adult
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.05.006

Abstract Background Cardiovascular disease is the main cause of mortality after renal transplantation. Left ventricular hypertrophy (LVH) is considered to be an independent predictor of cardiovascular events. The main risk factors for LVH after renal transplantation are anemia and hypertension. In hypertensive and renal transplant patients, ambulatory blood pressure monitoring (ABPM) has been demostrated to be more closely related to LVH than office blood pressure. The aim of this study has to evaluate LVH after renal transplantation, particularly its association with measures derived from ABPM and cardiovascular risk factors. Patients and methods Between March 2005 and October 2006, we recruited 101 consecutive kidney transplant patients to calculate left ventricular mass index (LVMI) by ecocardiography at 3, 12, and 24 months. Hypertension was evaluated by office blood pressure measurements at 3, 12, and 24 months and also by ABPM at 3 months. Clinical and laboratory data were recorded during the study. Results From 3 to 24 months LVMI was reduced from 129 ± 29 g/m2 to 121 ± 34 g/m2 ( P = .0089). Multivariate stepwise regression analysis showed independent predictors of LVMI at 3 months to be hemoglobin at 1 month, day systolic blood pressure (SBP) derived from ABPM and donor age ( R = .50, P < .001). The independent predictors of LVMI at 12 months were day SBP derived from ABPM, hemoglobin at 1 month, and proteinuria at 12 months ( R = .55, P < .001). Office SBP at 12 months, proteinuria at 24 months, patient age and night diastolic blood pressure derived from ABPM at 3 months were independent predictors of LVMI at 24 months ( R = .71, P < .001). Conclusion We observed a significant reduction in LVMI after renal transplantation. The main contributors to LVMI were anemia and elevated blood pressures measured by ABPM.