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Abstract
Objectives:
Cardiovascular comorbidities secondarily to End Stage Renal Disease is one of the major determinants of early morbidity and mortality. Structural abnormalities such as Left Ventricular Hypertrophy (LVH), systolic dysfunction, and impaired arterial compliance are common among such patients. Renal transplantation is the game changer, that not only improves renal functions but also reverses cardiac defects. This study aimed to compare cardiac structural and functional abnormalities pre- and post-renal transplantation.
Methods:
We conducted a quasi-experimental study including 65 ESRD patients who underwent kidney transplantation and were followed for 12 months. Echocardiographic parameters, including left ventricular mass index (LVMI) and ejection fraction (EF), along with blood pressure and electrolyte status, were assessed pre- and post-transplant. The primary endpoints were regression of LVMI and improvement in systolic function (EF). Secondary outcomes included blood pressure control and normalization of electrolyte balance. Paired t-tests, Wilcoxon signed-rank tests, and chi-square tests were applied as appropriate.
Results:
At 12 months post-transplant, significant improvements were observed across cardiac parameters. Mean EF improved from 37.4 ± 5.8% to 44.8 ± 7.2% (p < 0.001), with 66.1% of patients showing a clinically meaningful recovery. LVMI decreased significantly from 141.6 ± 18.5 g/m² to 116.5 ± 15.3 g/m² (p < 0.001). Blood pressure improved markedly, with mean systolic BP reducing from 159.7 ± 11.2 mmHg to 136.0 ± 10.7 mmHg (p < 0.001), and 68% achieving optimal control (<130/80 mmHg) at follow-up. Electrolyte balance, including potassium and calcium-phosphate, normalized in the majority of patients.
Conclusion:
Kidney transplantation leads to a significant reversal of adverse cardiac remodeling, including regression of LVH and improvement in systolic function, alongside better blood pressure control and electrolyte normalization. These findings highlight the potential of renal transplantation not only as a renal replacement therapy but also as a key intervention in cardiovascular recovery in ESRD patients. Further multicenter studies with longer follow-up are warranted to refine post-transplant cardiovascular management strategies.