Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Nov 6, 2016; 5(6): 517-523
Published online Nov 6, 2016. doi: 10.5527/wjn.v5.i6.517
Impact of renal transplantation on cardiac morphological and functional characteristics in children and adults
Sahier Omar El-Khashab, Eman El-Sayed Mohamed, Mahmoud A Soliman, Hussein Heshmat Kassem, Amin Roshdy Soliman
Sahier Omar El-Khashab, Eman El-Sayed Mohamed, Amin Roshdy Soliman, Department of Nephrology, Kasr Al-Ainy Cairo University, Cairo 11451, Egypt
Mahmoud A Soliman, Department of Medicine, Kasr Al-Ainy Cairo University, Cairo 11451, Egypt
Hussein Heshmat Kassem, Department of Cardiology, Kasr Al-Ainy Cairo University, Cairo 11451, Egypt
Author contributions: All the authors contributed to the paper.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board at Kasr Al-Ainy Cairo University.
Informed consent statement: An informed consent has been obtained from all patients at the beginning of the work.
Conflict-of-interest statement: The authors whose names are listed immediately below certify that they have no affiliations with or involvement in any organization or entity with any fi nancial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
Data sharing statement: No data were created so no data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Amin Roshdy Soliman, MD, PhD, FASN, Professor of Medicine and Nephrology, Department of Nephrology, Kasr Al-Ainy Cairo University, 41 Manial street, Cairo 11451, Egypt. aminroshdy@yahoo.com
Telephone: +20-2-22912555 Fax: +20-2-24194949
Received: June 12, 2016
Peer-review started: June 20, 2016
First decision: July 11, 2016
Revised: August 29, 2016
Accepted: September 13, 2016
Article in press: September 18, 2016
Published online: November 6, 2016
Processing time: 144 Days and 3 Hours
Abstract
AIM

To compare the effects of renal transplantation on cardiac functions in children and adults.

METHODS

One hundred and ten patients attending the nephrology outpatient clinic were enrolled in this study and were divided into six groups. The first two groups consisted each of 30 renal transplant patients who had a successful renal transplantation more than six months, but less than one year. Group I were less than 18 years and group II were more than 18 years. The third and fourth groups, each were 20 chronic renal failure patients on regular hemodialysis. Again, group III were less than 18 years and group IV were more than 18 years. Group V and VI (The control Groups) consisted each of 5 subjects below and above 18 years of age, respectively with normal kidney functions. All patients were subjected to history and examination. The kidney functions and the hemoglobin were analyzed. After obtaining informed consent, echocardiography was done to all patients.

RESULTS

There was a statistically significant improvement (P < 0.0001) in all cardiac parameters. A regression in left ventricular end diastolic volume (LVED) both in children (4.7 ± 0.8 to 4.2 ± 0.5) and in adults (5.9 ± 0.7 to 4.9 ± 0.6) were found. There was a regression in left ventricular end systolic volume (LVES) both in children (3.1 ± 0.6 to 2.4 ± 0.4) and in adults (4.1 ± 0.9 to 3.1 ± 0.5). Fractional shortening improves both in children (32.6 ± 5.3 to 41.7 ± 7.6) and in adults (29.0 ± 6.6 to 36.5 ± 4.1). The improvement in ejection fraction (EF) was higher in children (59.7 ± 7.0 to 71.9 ± 6.1) than in adults (52.0 ± 12.5 to 64.8 ± 5.9). However, this degree of improvement (in children: 12.2 ± 5.1) did not show statistical difference (P-value 0.8), when compared to adults (12.7 ± 9.8).

CONCLUSION

After renal transplantation cardiac functions and morphology (EF/LVED/LVES) do improve markedly and rapidly in both children and adults.

Keywords: Echocardiography chronic renal disease; Renal transplantation; Cardiac problems

Core tip: Cardiac functions do improve in chronic kidney disease patients after renal transplantation. This improvement is evident even in the early post-transplant period. In our study, we concluded that this improvement is even more marked in children. Renal transplantation in children with end-stage rend disease should, therefore, be encouraged.