The Beneficial Effects of Renal Transplantation on Uremic Cardiomyopathy

Background & Purpose: Although uremic cardiomyopathy (UC) is often associated with end-stage renal disease (ESRD) characterized by left ventricular (LV) hypertrophy and reduced ejection fraction (EF), the optimal therapy for UC has not been established. This study tested the hypothesis that renal transplantation (RT) leads to improvement of LV remodeling/function. Methods: A total of 48 ESRD patients were divided into two groups: recipients who underwent RT (RT; n = 28) and hemodialysis continuation patients (HD; n = 20). RT patients were further divided into reduced-EF (<50%, REF, n = 10) and preserved-EF (>50%, PEF, n = 18) groups. The echocardiographic data were obtained at 1-, 6-, and 12-month after RT. The patients with ischemic heart disease were excluded. Results: In HD patients, we found no obvious change in LV mass index (LVMI), LV end-diastolic volume (LVEDV), and LVEF during follow-up. In RT patients, LVMI and LVEDV significantly decreased at 12-month after RT, in which decrease in LVMI was more evident in REF than that in PEF (-27 ± 5 and -8 ± 7% respectively, P < .05). The LVEF time-dependently increased in REF (from 46 ± 3 to 71 ± 4% during 12-month, P < .0001), albeit not obvious in PEF. Of note, the improvement of LVEF after RT had strong negative correlation with basal EF value (r = -0.92, P < .001). Conclusion: RT leads to LV reverse remodeling. The functional improvement of LV was more evident in UC recipients.