Long‐term impact of renal transplantation on carotid artery properties and on ventricular hypertrophy in end‐stage renal failure patients

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Abstract
Background. The aim of this study was to examine prospectively the impact of renal transplantation on the morphological and functional characteristics of the carotid arteries and heart in a group of end‐stage renal failure patients without overt cardiovascular disease, followed up for >3 years. Methods. Twenty‐two patients were evaluated 2–3 weeks after renal transplantation, and again 12 and 40 months post‐transplant, using high resolution ultrasound imaging and echocardiography. Results. Kidney and patient survival were 100% at the end of follow‐up without any major cardiovascular events. After 40±1.2 months, carotid morphological parameters were normalized: carotid intima‐media thickness fell from 788±24 to 676±32 μm (PPP2, PP2, Pvs 22±2.4, not significant (NS)) and LV compliance (early to atrial flow ratio: 1.2±0.1 vs 1.3±0.1, NS) remained abnormal, and normalization of the LV mass was attained by only 25% of the patients with LV hypertrophy on baseline. Multiple stepwise regression analysis showed that the rate of change of reduction of the intima‐media thickness was influenced by age (negative association, PPPPPConclusions. Successful renal transplantation improves but does not cause complete regression of the cardiovascular alterations of end‐stage renal disease. Only intima‐media thickness was normalized by transplantation, whereas LVMI and carotid and ventricular distensibility remained abnormal. The results suggest that extended duration of dialysis, weight gain, high blood pressure and high haematocrit may adversely affect the rate of change of post‐transplant cardiovascular hypertrophy.