High morbidity and death rates are caused by cardiovascular disease in people with renal failure. Systemic illness, autosomal dominant polycystic kidney disease (ADPKD) causes a number of cardiac problems. There are few details on the cardiovascular characteristics and development of ADPKD patients receiving kidney transplantation (KT).
Major adverse cardiovascular events (MACEs) following transplantation and echocardiographic data within 2 years before KT (1993-2020) were obtained. Assessing cardiovascular abnormalities on echocardiography at the time of transplantation in patients with ADPKD in comparison to patients without ADPKD who were matched by sex (males made up 59.4% of the population) and age at transplantation (57.2±8.8 years) is the main outcome.
Patients with ADPKD (n=271) at the time of KT had lower rates of left ventricular hypertrophy (LVH) (39.4% vs. 66.4% vs. 48.6%), mitral regurgitation (2.7% vs. 6.3% vs. 7.45), and tricuspid regurgitation (1.8% vs. 6.6% vs. 7.2%) than those with diabetic nephropathy (DN, n=271) and nondiabetic, patients without ADPKD (NDNA) (n=271). At the time of transplantation, patients with ADPKD exhibited lower levels of systolic (5.6%) and diastolic (25.3%) dysfunction. Patients with ADPKD had the best post-transplantation survival (18.7 years on average vs. 12.0 for diabetic nephropathy [DN] and 13.8 years for nondiabetic non-ADPKD [NDNA]; P < 0.01) and the best MACE-free survival rate (hazard ratio = 0.51; P< 0.001). After transplantation, patients with ADPKD experienced impairment of their valve function and an increase in the sinus of Valsalva diameter (38.2 vs. 39.9 mm, P<0.01).
In comparison to patients with other kidney disorders, ADPKD transplant recipients have the most favorable cardiac profile prior to transplantation, with higher patient survival and MACE-free survival rates but decreasing valve function and rising sinus of Valsalva diameter.
Reference: sciencedirect.com/science/article/pii/S2468024922014486
