Left ventricular hypertrophy (LVH) is a risk factor for cardiovascular disease, and it is prevalent in children with end-stage renal disease (ESRD) and after renal transplantation (RTx) on cross-sectional studies. Our aim was to compare prospectively left ventricular mass index (LVMI) in children with ESRD, before and after RTx. Thirteen patients aged 1.5–15 years underwent echocardiogram prior to and at least 3 months after RTx, and again in the second year after transplantation. A control group consisted of children with ESRD who remained on dialysis. Systolic and diastolic blood pressure index decreased significantly over the study period only in the children who had undergone RTx. Mean LVMI in children with ESRD decreased from 45.4 ± 12.6 g/m2.7 to 34.9 ± 10.4 g/m2.7 after RTx (P = 0.001), but it remained unchanged in patients who remained on dialysis. The prevalence of LVH decreased from 54% to 8% (P = 0.03) after RTx. Systolic and diastolic blood pressure index were correlated with LVMI. Mean body mass index increased during the study period from 17.3 ± 2.5 to 20 ± 4.6 (P = 0.05); however, no correlation was found with LVMI. LVH in children with ESRD is potentially reversible after RTx, especially with good control of hypertension.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
McDonald SP, Craig JC (2004) Long-term survival of children with end-stage renal disease. N Engl J Med 350:2654–2662
United States Renal Data System (2001) Excerpts from the USRDS 2001 annual report. Am J Kidney Dis 38 [Suppl 3]:S147–S158
Middleton RJ, Parfrey PS, Foley RN (2001) Left ventricular hypertrophy in the renal patient. J Am Soc Nephrol 12:1079–1084
Becker-Cohen R, Nir A, Rinat C, Feinstein S, Algur N, Farber B, Frishberg Y (2006) Risk factors for cardiovascular disease in children and young adults after renal transplantation. Clin J Am Soc Nephrol 1:1284–1292
El-Husseini AA, Sheashaa HA, Hassan NA, El-Demerdash FM, Sobh MA, Ghoneim MA (2004) Echocardiographic changes and risk factors for left ventricular hypertrophy in children and adolescents after renal transplantation. Pediatr Transplant 8:249–254
Matteuci MG, Giordano U, Calzolari A, Turchetta A, Santillli A, Rizzoni G (1999) Left ventricular hypertrophy, treadmill tests, and 24-hour blood pressure in pediatric transplant patients. Kidney Int 56:1566–1570
Kitzmueller E, Vecsei A, Pichler J, Bohm M, Muller T, Vargha R, Csaicsich D, Aufricht C (2004) Changes of blood pressure and left ventricular mass in pediatric renal transplantation. Pediatr Nephrol 19:1385–1389
Mitsnefes MM, Kimball TR, Border WL, Witt SA, Glassock BJ, Khoury PR, Daniels SR (2004) Abnormal cardiac function in children after renal transplantation. Am J Kidney Dis 43:721–726
Kessler M, Zannad F, Lehert P, Grunfeld JP, Thuilliez C, Leizorovicz A, Lechat P, FOSIDIAL investigators (2007) Predictors of cardiovascular events in patients with end-stage renal disease: an analysis from the Fosinopril in Dialysis study. Nephrol Dial Transplant 22:3573–3579
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576
DeSimone G, Daniels SR, Devereux RB, Koren MJ, Meye RA, Laragh JH (1992) Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol 20:1251–1260
Khoury PR, Daniels SR, Gidding SS, Kimball TR (2004) Left ventricular mass index in children: what is the right index? J Am Soc Echocardiogr 17:555
Paoletti E, Cassottana P, Amidone M, Gherzi M, Rolla D, Cannella G (2007) ACE inhibitors and persistent left ventricular hypertrophy after renal transplantation: a randomized clinical trial. Am J Kidney Dis 50:133–142
Ferreira SR, Moises VA, Tavares A, Pacheo-Silva A (2002) Cardiovascular effects of successful renal transplantation: a 1-year sequential study of left ventricular morphology and function, and 24-hour blood pressure profile. Transplantation 74:1580–1587
Hernandez D, Lacalzada J, Salido E, Linares J, Barragan A, Lorenzo V, Higueras L, Martin B, Rodríguez A, Laynez I, Gonzalez-Posada JM, Torres A (2000) Regression of left ventricular hypertrophy by lisinopril after renal transplantation: role of ACE gene polymorphism. Kidney Int 58:889–897
Johnstone LM, Jones CL, Grigg LE, Wilkinson JL, Walker RG, Powell HR (1996) Left ventricular abnormalities in children, adolescents and young adults with renal disease. Kidney Int 50:998–1006
Mitsnefes MM, Schwartz SM, Daniels SR, Kimball TR, Khoury P, Strife CF (2001) Changes in left ventricular mass index in children and adolescents after renal transplantation. Pediatr Transplant 5:279–284
Kennedy DJ, Malhotra D, Shapiro JI (2006) Molecular insights into uremic cardiomyopathy: cardiotonic steroids and Na/K ATPase signaling. Cell Mol Biol 52:3–14
Espino G, Denney J, Furlong T, Fitzsimmons W, Nash RA (2001) Assessment of myocardial hypertrophy by echocardiography in adult patients receiving tacrolimus or cyclosporine therapy for prevention of acute GVHD. Bone Marrow Transplant 28:1097–1103
Radermacher J, Meiners M, Bramlage C, Kilem V, Behrend M, Schlitt HJ, Pichlmayr R, Koch KM, Brunkhorst R (1998) Pronounced renal vasoconstriction and systemic hypertension in renal transplant patients treated with cyclosporine A versus FK 506. Transpl Int 11:3–10
Ji SM, Li LS, Sha GZ, Chen JS, Liu ZH (2007) Conversion from cyclosporine to tacrolimus for chronic allograft nephrology. Transplant Proc 39:1402–1405
Pappas PA, Weppler D, Pinna AD, Rusconi P, Thompson JF, Jaffe JS, Tzakis AG (2000) Sirolimus in pediatric gastrointestinal transplantation: the use of sirolimus for pediatric transplant patients with tacrolimus-related cardiomyopathy. Pediatr Transplant 4:45–49
About this article
Cite this article
Becker-Cohen, R., Nir, A., Ben-Shalom, E. et al. Improved left ventricular mass index in children after renal transplantation. Pediatr Nephrol 23, 1545–1550 (2008). https://doi.org/10.1007/s00467-008-0855-5
- Left ventricular hypertrophy
- Renal transplantation