Background

The risk of cardiovascular death in patients on dialysis is dramatically elevated but can be reduced by renal transplantation. We previously showed that left atrial diameter at time of transplantation predicts cardiovascular and overall mortality. Now we investigated the association of changes in cardiac morphology after transplantation and mortality.

Methods

We retrospectively analysed data from the Austrian dialysis and transplant repository which was merged with the echocardiography data repositories at the transplant centres.

Results

We included 414 patients with a median follow-up of eight years and observed a significant progression of mean diameter of LA, RA and RV and a significant regression of LV. Patients, who showed a regression of initially enlarged LA diameter had a significantly lower risk of overall and cardiovascular mortality (HR 0.60 (95% CI 0.41-0.90, p<0.001, 139 deaths), and HR of 0.46 (95% CI 0.24-0.88, p=0.019, 55 CV deaths), respectively). LV diameter showed an overall regression, but was not associated with survival. Of the examined parameters age at transplantation, dialysis vintage, mode of dialysis, antihypertensive therapy, presence of diabetes and renal function, only age at transplantation OR 0.67 (CI 0.52-0.87, p=0.007) and pre-transplant peritoneal dialysis (PD) OR 2.27 (95% CI 1.08-4.76, p=0.031) were significantly associated with a regression of LA.

Conclusions

In conclusion, patients with regression of LA after kidney transplantation exhibited a longer overall survival and lower CV mortality risk. Besides age, PD and antihypertensive therapy were mediators of LA regression.

CITATION INFORMATION: Kainz A., Regele F., Kammer M., Beer A., Steringer-Mascherbauer R., Binder T., Oberbauer R. Regression of Left Atrial Diameter after Kidney Transplantation is Associated with Prolonged Survival: An Observational Study Am J Transplant. 2017;17 (suppl 3).

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