Long-term cardiovascular effects of pre-transplant native kidney nephrectomy in children

Marco Cavallini, Giacomo Di Zazzo, Ugo Giordano, Giacomo Pongiglione, Luca Dello Strologo, Nicola Capozza, Francesco Emma, Maria Chiara Matteucci

Research output: Contribution to journalArticlepeer-review

Abstract

Left ventricular (LV) hypertrophy (H) and hypertension are prevalent in children with end-stage renal disease (ESRD) and after renal transplantation. Severe hypertension prior to renal transplantation has traditionally been an indication for native kidney nephrectomy. The impact of nephrectomy on cardiovascular disease has not been well documented. We retrospectively evaluated echocardiographic and ambulatory blood pressure monitoring (ABPM) data in 67 young adults who had undergone transplantation in the pediatric age with a mean follow-up of 10.4 years. Unilateral or bilateral nephrectomies had been performed in 32 patients. The number of antihypertensive drugs used prior to transplantation was significantly higher in the nephrectomized groups. At follow-up the amount of antihypertensive medications was similar between groups and no significant differences were observed in mean arterial blood pressure (MAP) or LV mass index (LVMi). LVH was observed in 50% of non-nephrectomized patients, 45.4% of patients with unilateral nephrectomy, and 44.4% of patients without native kidneys (p = n.s.). In conclusion, unilateral or bilateral nephrectomies prior to transplantation do not appear to influence blood pressure control or the prevalence of LVH after renal transplantation. Longitudinal studies with repeated assessment of LVMi, before and after renal transplantation, are needed to assess the impact of residual activity of native kidneys on arterial blood pressure and cardiac structural changes, even in normotensive patients, to evaluate cardiovascular morbidity.

Original languageEnglish
Pages (from-to)2523-2529
Number of pages7
JournalPediatric Nephrology
Volume25
Issue number12
DOIs
Publication statusPublished - Dec 2010

Keywords

  • Blood pressure
  • Cardiac hypertrophy
  • Renal transplantation
  • Ventricular mass

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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