Impact of Renal Transplantation on Uremic Cardiomyopathy. 
Soraia R. Ferreira, Ricardo Sesso, Odair Marson, Jose Osmar Medina Pestana, Alvaro Pacheco-Silva.
Nephrology, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil.

Heart disease is the most common cause of death in dialysis patients. Uremic Cardiomyopathy may manifest as concentric left ventricular (LV) hypertrophy, LV dilatation with or whithout hypertrophy, or systolic dysfunction. In order to determine the impact of successful renal ransplantation on uremic cardiomyophahthy we selected 25 adult patients on hemodialysis who were candidates to receive a living related allograft. Clinical and laboratory assessment, ambulatory blood pressure monitoring and echocardiography were performed before Tx and 1, 3, 6 and 12 months post transplant. Diabetic patients were not included and all patients maintained a good renal function during the study (Creatinine 2.0
mg/dl). One year after the trnsplant the patients had an improvement on hematology and biochemical parameters and a significant lower mean systolic blood pressure (MSBP), when compared to before the Tx.
In univariate regression analysis we found a significant correlation (p<0.05) between one year left ventricular mass index (LVMI) and pre Tx body weight, pre Tx cholesterol, pre Tx LVMI, post Tx MSBP. In a
multivariate analysis pre Tx LVMI, body weight, cholesterol and post Tx presence of patent arterious-venous fistula were correlated to one year post Tx LVMI. At echocardiography analysis one year post Tx the majority (80%) of the patients had a significant reduction in LV mass (p<0.01) and in LV
dilatation (p<0.003). Furthermore, 10 patients (40%) had normal echocardiography, compared to only 2 (8%) before Tx. We conclude that successful kidney transplant has a beneficial impact on uremic
cardiomyopathy, wether manifested by concentric LV hypertrophy or LV dilatation.

Poster Session: Clinical Transplantation: Complications (9:00 AM-4:30 PM)

Presentation Date: Saturday, November 6, 1999, Time: 9:00AM, Room: Halls B and C