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ERA-EDTA: Left Ventricular Hypertrophy After Renal Transplantation Linked to Poor Outcome

By Alison Palkhivala

COPENHAGEN, DENMARK -- July 18, 2002 -- The presence of left ventricular hypertrophy (LVH) after renal transplantation is a risk factor for death and congestive heart failure (CHF), according to a retrospective study.

In light of these findings, researchers from University of Manitoba, Winnipeg, Canada, suggest that controlling anaemia and hypertension may help prevent the development of LVH in this patient population.

The results of this study were presented here on July 17 at the 39^th annual Congress of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA).

To determine the causes and consequences of LVH in kidney transplant patients, Dr. Claudio Rigatto and colleagues evaluated 473 patients who were alive and free of cardiac disease one year after surgery.

The investigators used electrocardiographic (ECG) data to identify the presence of LVH. ECG data were available for 416 patients one year after renal transplantation and for 284 patients five years after transplantation. Baseline characteristics were similar for patients with and without available ECG data.

According to the ECG data, 57 of 416 patients had LVH in the first year following renal transplantation, and 38 of 284 patients had LVH in the fifth year. Of the 38 patients with electrocardiographic LVH at year 5, 18 did not have LVH at one year.

The presence of LVH at year 1 or year 5 was associated with an increased risk of death and CHF. These associations were independent of age, the presence of diabetes, gender, blood pressure, graft rejection, smoking, and cadaveric donation.

The presence of anaemia and elevated diastolic blood pressure were independently associated with an increasing Cornell voltage over the five years, which is a validated marker of LV mass. Only elevated systolic blood pressure predicted the presence of de novo LVH at five years.

The researchers concluded that LVH is a significant risk factor for death and CHF in renal transplant patients.

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