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Longitudinal assessment of cardiac morphology and function following kidney transplantation
Author(s) -
Kensinger Clark,
Hernandez Antonio,
Bian Aihua,
Fairchild Meagan,
Chen Guanhua,
Lipworth Loren,
Ikizler T. Alp,
Birdwell Kelly A.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12864
Subject(s) - medicine , cardiology , transplantation , ejection fraction , kidney transplantation , body mass index , population , prospective cohort study , renal function , risk factor , fibroblast growth factor 23 , mass index , heart failure , parathyroid hormone , environmental health , calcium
Background Abnormal cardiac morphology is a risk factor for cardiovascular complications in kidney transplant patients. A supraphysiologic level of fibroblast growth factor 23 ( FGF ‐23) has been associated with myocardial hypertrophy in this patient population. Our aim was to evaluate the change in cardiac morphology and function following kidney transplantation and to evaluate the association between the change in FGF ‐23 concentrations and cardiac morphology. Methods We performed a longitudinal, prospective cohort study of 143 kidney transplant recipients (73% male, 75% white) measuring left ventricular ( LV ) mass index, left atrial ( LA ) volume index, and ejection fraction ( EF ) by echocardiography at months 1, 12, and 24 post‐transplant. FGF ‐23 levels were measured at months 1 and 24 post‐transplant. Results Unadjusted and adjusted linear mixed‐effects models were used to examine changes in outcomes over time. In the adjusted model, LV mass index ( P <.001) and LA volume index ( P <.001) decreased and EF ( P =.009) increased significantly over time. There was a significant association between decreasing FGF ‐23 levels and improving LV mass index following transplant ( P =.036) in the unadjusted model; however, there was no significant relationship in the adjusted model (0.195). Conclusion Understanding the progression of unique cardiovascular risk factors associated with kidney transplantation may provide potential opportunities to improve survival.