Effects of Kidney Transplantation on Valvular Heart Diseases

Transplant Proc. 2021 Jun;53(5):1433-1438. doi: 10.1016/j.transproceed.2021.01.043. Epub 2021 Apr 2.

Abstract

Introduction: In patients with end-stage renal failure, hypervolemia frequently causes increased cardiac output, especially in patients who are under-dialyzed and those with cardiac decompensation.

Objective: This study aimed to examined the effect of kidney transplantation on valvular heart diseases.

Patients and methods: This retrospective data analysis included adult patients (n = 180) who underwent kidney transplantation between February 2015 and June 2018 at the Division of Organ Transplantation, University of Debrecen, Hungary. This study examined the echocardiographic parameters and laboratory results preoperatively and postoperatively (at 6 and 12 months). Statistical analyses were performed using the χ2/Fisher exact tests and Kruskal-Wallis analysis of variance test. P < .05 was considered significant.

Results: No mitral regurgitation (MR) was observed preoperatively in 27% of the patients, while 62% had grade 1 MR, and 11% had grade 2 MR. Grade 2 MR was reduced from 11% to 2% twelve months after kidney transplantation (P = .03). Valvular calcification was detected preoperatively in 21.5% of the study population but was detected in 25.8% 6 months postoperation and in 35.5% 12 months postoperation (P = .09). At 12-month follow-up, 30.8% of patients without diabetes and 60% (P = .03) of patients with diabetes had valvular calcification.

Conclusion: Significant improvement was noted in patients with moderate-stage MR because renal transplantations decrease the volume overload on the heart. After surgical intervention, elevation in the incidence of calcified valves among patients with diabetes was significant compared to patients without diabetes.

MeSH terms

  • Adult
  • Aged
  • Calcinosis / diagnosis
  • Calcinosis / etiology
  • Echocardiography
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hungary
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / diagnosis*
  • Mitral Valve Insufficiency / etiology
  • Postoperative Period
  • Tricuspid Valve Insufficiency / diagnosis
  • Tricuspid Valve Insufficiency / etiology
  • Young Adult