Tricuspid Regurgitation and Kidney Transplant Recipient Outcomes.
| Autor: | Skalsky K; Department of Cardiology, Rabin Medical Center, Petach-Tikva, Israel (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel)., Perl L; Department of Cardiology, Rabin Medical Center, Petach-Tikva, Israel (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel)., Steinmetz T; Department of Nephrology, Rabin Medical Center, Petach-Tikva, Israel (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel)., Zvi BR; Department of Nephrology, Rabin Medical Center, Petach-Tikva, Israel (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel)., Atamna M; Department of Nephrology, Rabin Medical Center, Petach-Tikva, Israel (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel)., Shapira Y; Department of Cardiology, Rabin Medical Center, Petach-Tikva, Israel (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel)., Kornowski R; Department of Cardiology, Rabin Medical Center, Petach-Tikva, Israel (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel)., Shiyovich A; Department of Cardiology, Rabin Medical Center, Petach-Tikva, Israel (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel)., Rahamimov R; Department of Nephrology, Rabin Medical Center, Petach-Tikva, Israel (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel)., Vaturi M; Department of Cardiology, Rabin Medical Center, Petach-Tikva, Israel (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel). |
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| Jazyk: | angličtina |
| Zdroj: | Kidney medicine [Kidney Med] 2024 Mar 15; Vol. 6 (5), pp. 100808. Date of Electronic Publication: 2024 Mar 15 (Print Publication: 2024). |
| DOI: | 10.1016/j.xkme.2024.100808 |
| Abstrakt: | Rationale & Objective: Kidney function can be adversely affected by significant tricuspid regurgitation (TR) owing to effects on cardiac output and systemic venous congestion. However, the impact of significant TR on short- and long-term kidney function following a kidney transplant remains uncertain. Study Design: Retrospective observational cohort. Setting & Participants: Kidney transplant recipients from a single center between 2016 and 2019. Exposure: Significant TR, defined by at least moderate regurgitation, on echocardiogram before kidney transplantation. Outcomes: Primary end points included the estimated glomerular filtration rate (eGFR) at the following 3 time points: 2 weeks, 3 months, and 1 year after transplantation. Secondary end points included major adverse cardiac events including nonfatal myocardial infarction, all-cause mortality, and hospitalization owing to cardiovascular disease. Analytical Approach: Propensity score matching was performed in 1:3 ratio between patients treated with significant TR and controls, within a caliper 0.05 standard deviation of the propensity score, to analyze for the primary end point. Results: Among 557 kidney transplant recipients, 26 (5%) exhibited significant TR pretransplantation. According to propensity score matching analysis, with 1:3 ratio between 24 patients with significant TR and 72 controls, the presence of significant TR was associated with a lower eGFR posttransplantation. Specifically, the mean eGFR was 41.2 mL/min/1.73 m 2 compared to 53.3 mL/min/1.73 m 2 at 2 weeks ( P < 0.01), 50.0 mL/min/1.73 m 2 versus 60.3 mL/min/1.73 m 2 at 3 months ( P < 0.01), and 49.4 mL/min/1.73 m 2 versus 61.2 mL/min/1.73 m 2 at 1 year ( P < 0.01). Delayed graft function was observed in 41.7% of the patients with significant TR compared to 12.5% of those without significant TR ( P < 0.01). No patients with significant TR required dialysis after 1 year. 1-year major adverse cardiac events were nonsignificantly higher among patients with significant TR (20.8% vs 8.1%; P = 0.16). Limitations: Retrospective design and relatively small TR population. Conclusions: The presence of significant TR among kidney transplant recipients was associated with a lower eGFR at 2 weeks, 3 months, and 1 year following transplant, although all remained dialysis independent at 1 year. (© 2024 The Authors.) |
| Databáze: | MEDLINE |
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