Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients
Hon-Chun Hsu,1,2 Gavin R Norton,1 Ferande Peters,1 Chanel Robinson,1 Noluntu Dlongolo,3 Ahmed Solomon,4 Gloria Teckie,5 Angela J Woodiwiss,1 Patrick H Dessein1,6,7 1Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwater...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2021-07-01
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| Series: | International Journal of Nephrology and Renovascular Disease |
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| Online Access: | https://www.dovepress.com/association-of-post-transplantation-anaemia-and-persistent-secondary-h-peer-reviewed-fulltext-article-IJNRD |
| _version_ | 1818956789208580096 |
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| author | Hsu HC Norton GR Peters F Robinson C Dlongolo N Solomon A Teckie G Woodiwiss AJ Dessein PH |
| author_facet | Hsu HC Norton GR Peters F Robinson C Dlongolo N Solomon A Teckie G Woodiwiss AJ Dessein PH |
| author_sort | Hsu HC |
| collection | DOAJ |
| description | Hon-Chun Hsu,1,2 Gavin R Norton,1 Ferande Peters,1 Chanel Robinson,1 Noluntu Dlongolo,3 Ahmed Solomon,4 Gloria Teckie,5 Angela J Woodiwiss,1 Patrick H Dessein1,6,7 1Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Nephrology Unit, Milpark Hospital, Johannesburg, South Africa; 3Rheumatology Unit, Rosebank Hospital, Johannesburg, South Africa; 4Division of Rheumatology, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; 5Division of Nephrology, Department of Medicine, Chris Hani Baragwanath Hospital and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; 6Internal Medicine Department, University of the Witwatersrand, Johannesburg, South Africa; 7Internal Medicine Department, Free University and University Hospital, Brussels, BelgiumCorrespondence: Patrick H DesseinCardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 80 Scholtz Road, Norwood, 2117, Johannesburg, South AfricaTel +27662491468Email patrick.dessein22@gmail.comIntroduction: We hypothesized that post transplantation anaemia and persistent secondary hyperparathyroidism are potential determinants of diastolic function in stable kidney transplant recipients.Methods: We assessed traditional and non-traditional cardiovascular risk factors and determined carotid artery intima-media thickness and plaque by ultrasound, arterial function by applanation tonometry using SphygmoCor software and diastolic function by echocardiography in 43 kidney transplant recipients with a transplant duration of ≥ 6 months, no acute rejection and a glomerular filtration rate of ≥ 15 mL/min/1.73m2.Results: Mean (SD; range) transplant duration was 12.3 (8.0; 0.5– 33.8) years. Post transplantation anaemia and persistent secondary hyperparathyroidism were identified in 27.9% and 30.8% of the patients, respectively; 67.5% of the participants were overweight or obese. In established confounder adjusted analysis, haemoglobin (partial R=− 0.394, p=0.01) and parathyroid hormone concentrations (partial R=0.382, p=0.02) were associated with E/e’. In multivariable analysis, haemoglobin (partial R=− 0.278, p=0.01) and parathyroid levels (partial R=0.324, p=0.04) were independently associated with E/e’. Waist–height ratio (partial R=− 0.526, p=0.001 and partial R=− 0.355, p=0.03), waist circumference (partial R=− 0.433, p=0.008 and partial R=− 0.393, p=0.02) and body mass index (partial R=− 0.332, p=0.04 and partial R=− 0.489, p=0.002) were associated with both e’ and E/A, respectively, in established confounder adjusted analysis. The haemoglobin-E/e’ (partial R=− 0.422, p=0.02), parathyroid hormone-E/e’ (partial R=0.434, p=0.03), waist–height ratio-e’ (partial R=− 0.497, p=0.007) and body mass index-E/A (partial R=− 0.386, p=0.04) relationships remained consistent after additional adjustment for left ventricular mass index and cardiac preload and afterload measures.Conclusion: Haemoglobin and parathyroid hormone concentrations as well as adiposity measures are independently associated with diastolic function in kidney transplant recipients. Whether adequate management of post transplantation anaemia, persistent secondary hyperparathyroidism and excess adiposity can prevent the development of heart failure with preserved ejection fraction in kidney transplant recipients merits further investigation.Keywords: haemoglobin, parathyroid hormone, obesity, diastolic function, kidney transplantation |
| first_indexed | 2024-12-20T10:59:32Z |
| format | Article |
| id | doaj.art-8c99ee1d00c944158c919cf32d57e767 |
| institution | Directory Open Access Journal |
| issn | 1178-7058 |
| language | English |
| last_indexed | 2024-12-20T10:59:32Z |
| publishDate | 2021-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of Nephrology and Renovascular Disease |
| spelling | doaj.art-8c99ee1d00c944158c919cf32d57e7672022-12-21T19:43:03ZengDove Medical PressInternational Journal of Nephrology and Renovascular Disease1178-70582021-07-01Volume 1421122366538Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant RecipientsHsu HCNorton GRPeters FRobinson CDlongolo NSolomon ATeckie GWoodiwiss AJDessein PHHon-Chun Hsu,1,2 Gavin R Norton,1 Ferande Peters,1 Chanel Robinson,1 Noluntu Dlongolo,3 Ahmed Solomon,4 Gloria Teckie,5 Angela J Woodiwiss,1 Patrick H Dessein1,6,7 1Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Nephrology Unit, Milpark Hospital, Johannesburg, South Africa; 3Rheumatology Unit, Rosebank Hospital, Johannesburg, South Africa; 4Division of Rheumatology, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; 5Division of Nephrology, Department of Medicine, Chris Hani Baragwanath Hospital and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; 6Internal Medicine Department, University of the Witwatersrand, Johannesburg, South Africa; 7Internal Medicine Department, Free University and University Hospital, Brussels, BelgiumCorrespondence: Patrick H DesseinCardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 80 Scholtz Road, Norwood, 2117, Johannesburg, South AfricaTel +27662491468Email patrick.dessein22@gmail.comIntroduction: We hypothesized that post transplantation anaemia and persistent secondary hyperparathyroidism are potential determinants of diastolic function in stable kidney transplant recipients.Methods: We assessed traditional and non-traditional cardiovascular risk factors and determined carotid artery intima-media thickness and plaque by ultrasound, arterial function by applanation tonometry using SphygmoCor software and diastolic function by echocardiography in 43 kidney transplant recipients with a transplant duration of ≥ 6 months, no acute rejection and a glomerular filtration rate of ≥ 15 mL/min/1.73m2.Results: Mean (SD; range) transplant duration was 12.3 (8.0; 0.5– 33.8) years. Post transplantation anaemia and persistent secondary hyperparathyroidism were identified in 27.9% and 30.8% of the patients, respectively; 67.5% of the participants were overweight or obese. In established confounder adjusted analysis, haemoglobin (partial R=− 0.394, p=0.01) and parathyroid hormone concentrations (partial R=0.382, p=0.02) were associated with E/e’. In multivariable analysis, haemoglobin (partial R=− 0.278, p=0.01) and parathyroid levels (partial R=0.324, p=0.04) were independently associated with E/e’. Waist–height ratio (partial R=− 0.526, p=0.001 and partial R=− 0.355, p=0.03), waist circumference (partial R=− 0.433, p=0.008 and partial R=− 0.393, p=0.02) and body mass index (partial R=− 0.332, p=0.04 and partial R=− 0.489, p=0.002) were associated with both e’ and E/A, respectively, in established confounder adjusted analysis. The haemoglobin-E/e’ (partial R=− 0.422, p=0.02), parathyroid hormone-E/e’ (partial R=0.434, p=0.03), waist–height ratio-e’ (partial R=− 0.497, p=0.007) and body mass index-E/A (partial R=− 0.386, p=0.04) relationships remained consistent after additional adjustment for left ventricular mass index and cardiac preload and afterload measures.Conclusion: Haemoglobin and parathyroid hormone concentrations as well as adiposity measures are independently associated with diastolic function in kidney transplant recipients. Whether adequate management of post transplantation anaemia, persistent secondary hyperparathyroidism and excess adiposity can prevent the development of heart failure with preserved ejection fraction in kidney transplant recipients merits further investigation.Keywords: haemoglobin, parathyroid hormone, obesity, diastolic function, kidney transplantationhttps://www.dovepress.com/association-of-post-transplantation-anaemia-and-persistent-secondary-h-peer-reviewed-fulltext-article-IJNRDhaemoglobinparathyroid hormoneobesitydiastolic functionkidney transplantation |
| spellingShingle | Hsu HC Norton GR Peters F Robinson C Dlongolo N Solomon A Teckie G Woodiwiss AJ Dessein PH Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients International Journal of Nephrology and Renovascular Disease haemoglobin parathyroid hormone obesity diastolic function kidney transplantation |
| title | Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients |
| title_full | Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients |
| title_fullStr | Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients |
| title_full_unstemmed | Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients |
| title_short | Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients |
| title_sort | association of post transplantation anaemia and persistent secondary hyperparathyroidism with diastolic function in stable kidney transplant recipients |
| topic | haemoglobin parathyroid hormone obesity diastolic function kidney transplantation |
| url | https://www.dovepress.com/association-of-post-transplantation-anaemia-and-persistent-secondary-h-peer-reviewed-fulltext-article-IJNRD |
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