Long-Term Impact of Arteriovenous Fistula Ligation on Cardiac Structure and Function in Kidney Transplant Recipients: A 5-Year Follow-Up Observational Cohort Study.

Autor:	Salehi T; Central Northern Adelaide Renal and Transplantation Service, Adelaide, South Australia, Australia.; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia., Montarello NJ; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia., Juneja N; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia., Stokes MB; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia., Scherer DJ; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia., Williams KF; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia., King D; Central Northern Adelaide Renal and Transplantation Service, Adelaide, South Australia, Australia., Macaulay E; Central Northern Adelaide Renal and Transplantation Service, Adelaide, South Australia, Australia., Russell CH; Central Northern Adelaide Renal and Transplantation Service, Adelaide, South Australia, Australia., Olakkengil SA; Central Northern Adelaide Renal and Transplantation Service, Adelaide, South Australia, Australia., Carroll RP; Central Northern Adelaide Renal and Transplantation Service, Adelaide, South Australia, Australia.; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia., Faull RJ; Central Northern Adelaide Renal and Transplantation Service, Adelaide, South Australia, Australia.; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia., Teo KSL; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia., McDonald SP; Central Northern Adelaide Renal and Transplantation Service, Adelaide, South Australia, Australia.; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia., Worthley MI; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia., Coates PT; Central Northern Adelaide Renal and Transplantation Service, Adelaide, South Australia, Australia.; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia., Rao NN; Central Northern Adelaide Renal and Transplantation Service, Adelaide, South Australia, Australia.; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Jazyk:	angličtina
Zdroj:	Kidney360 [Kidney360] 2021 May 18; Vol. 2 (7), pp. 1141-1147. Date of Electronic Publication: 2021 May 18 (Print Publication: 2021).
DOI:	10.34067/KID.0000692021
Abstrakt:	Background: The long-term effects of arteriovenous fistula (AVF) ligation on cardiovascular structure following kidney transplantation remain uncertain. A prospective randomized, controlled trial (RCT) examined the effect of AVF ligation at 6 months on cardiovascular magnetic resonance imaging (CMR)-derived parameters in 27 kidney transplant recipients compared with 27 controls. A mean decrease in left ventricular mass (LVM) of 22.1 g (95% CI, 15.0 to 29.1) was observed compared with an increase of 1.2 g (95% CI, -4.8 to 7.2) in the control group ( P <0.001). We conducted a long-term follow-up observational cohort study in the treated cohort to determine the evolution of CMR-derived parameters compared with those documented at 6 months post-AVF ligation. Methods: We performed CMR at long-term follow-up in the AVF ligation observational cohort from our original RCT published in 2019. Results were compared with CMR at 6 months postintervention. The coprimary end point was the change in CMR-derived LVM and LVM index at long-term follow-up from imaging at 6 months postindex procedure. Results: At a median of 5.1 years (interquartile range, 4.7-5.5 years), 17 patients in the AVF ligation group were studied with repeat CMR with a median duration to follow-up imaging of 5.1 years (IQR, 4.7-5.5 years). Statistically significant further reductions in LVM (-17.6±23.0 g, P =0.006) and LVM index (-10.0±13.0 g/m 2 , P =0.006) were documented. Conclusions: The benefit of AVF ligation on LVM and LVM index regression appears to persist long term. This has the potential to lead to a significant reduction in cardiovascular mortality. Competing Interests: R. Carroll reports consultancy agreements with HANSA Biopharma and research funding from Bristol Myers Squibb. P. Coates reports scientific advisor or membership with Transplantation Society of Australia & New Zealand. R. Faull reports scientific advisor or membership with the Polycystic Kidney Disease Australia Scientific Advisory Board. S. McDonald reports research funding from Atsellas and Baxter, honoraria from Nippro, and scientific advisor or membership with Fresenius Kidney Care Australia as a national clinical advisory committee member. All remaining authors have nothing to disclose. (Copyright © 2021 by the American Society of Nephrology.)
Databáze:	MEDLINE
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