Cardiorenal Syndrome in Renal Transplant Recipients: Prevalence, Clinical Presentation, Treatment, and Outcome.
Cardiorenal syndrome
Diuretic resistance
Renal transplantation
Ultrafiltration
Journal
Cardiorenal medicine
ISSN: 1664-5502
Titre abrégé: Cardiorenal Med
Pays: Switzerland
ID NLM: 101554863
Informations de publication
Date de publication:
2020
2020
Historique:
received:
28
01
2020
accepted:
31
03
2020
pubmed:
7
7
2020
medline:
11
8
2021
entrez:
7
7
2020
Statut:
ppublish
Résumé
Data on the cardiorenal syndrome (CRS) in renal transplant recipients (RTR) are scarce. We investigated the prevalence, clinical presentation, treatment, and outcomes of patients with CRS in our renal transplant cohort. Charts and medical records of adult RTR were investigated to identify patients with renal allograft dysfunction and heart failure (HF) with reduced (HFrEF) or preserved (HFpEF) ejection fraction. From December 2009 to December 2019, a total of 1,610 patients received a kidney allograft at our institution. CRS was diagnosed in 9 patients (0.56%) a median of 11 years after transplantation (4-20 years). Seven of the patients were male, and 2 were female. The median age when CRS was diagnosed was 71 years (64-80 years). The major presenting symptom was dyspnea. Five patients had HFrEF, and 4 had HFpEF. The patient's median basal creatinine clearance was 37 mL/min (range 29-77 mL/min). At hospitalization, it was decreased to 24 mL/min (range 13-45 mL/min). The patients were treated with diuretics, but 5 of them required extracorporeal fluid removal. At the 16-month follow-up (median), all patients with HFpEF were alive and had returned to initial levels of creatinine clearance. Two of the 5 HFrEF had died, and 2 needed permanent extracorporeal water removal. CRS after renal transplantation was rare (<1.0%), but CRS in HFreF patients was associated with a poor outcome.
Sections du résumé
BACKGROUND
Data on the cardiorenal syndrome (CRS) in renal transplant recipients (RTR) are scarce. We investigated the prevalence, clinical presentation, treatment, and outcomes of patients with CRS in our renal transplant cohort.
METHODS
Charts and medical records of adult RTR were investigated to identify patients with renal allograft dysfunction and heart failure (HF) with reduced (HFrEF) or preserved (HFpEF) ejection fraction.
RESULTS
From December 2009 to December 2019, a total of 1,610 patients received a kidney allograft at our institution. CRS was diagnosed in 9 patients (0.56%) a median of 11 years after transplantation (4-20 years). Seven of the patients were male, and 2 were female. The median age when CRS was diagnosed was 71 years (64-80 years). The major presenting symptom was dyspnea. Five patients had HFrEF, and 4 had HFpEF. The patient's median basal creatinine clearance was 37 mL/min (range 29-77 mL/min). At hospitalization, it was decreased to 24 mL/min (range 13-45 mL/min). The patients were treated with diuretics, but 5 of them required extracorporeal fluid removal. At the 16-month follow-up (median), all patients with HFpEF were alive and had returned to initial levels of creatinine clearance. Two of the 5 HFrEF had died, and 2 needed permanent extracorporeal water removal.
CONCLUSION
CRS after renal transplantation was rare (<1.0%), but CRS in HFreF patients was associated with a poor outcome.
Identifiants
pubmed: 32629448
pii: 000507728
doi: 10.1159/000507728
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
333-339Informations de copyright
© 2020 S. Karger AG, Basel.