Effect and correlation of patent vascular access flow on left ventricular hypertrophy in kidney transplant patients
Background: Patency of vascular accesses (VA) is associated with left ventricular hypertrophy (LVH) in kidney transplant recipients (KTR). This level of VA flow (VAF) as related to LVH was assessed and an upward level of VA flow recommended for VA closure determined. This recommendation has not been...
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Format: | Article |
Language: | English |
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Elsevier
2022-06-01
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Series: | International Journal of Cardiology: Heart & Vasculature |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906722000975 |
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author | Eakalak Lukkanalikitkul Burabha Pussadhamma Anucha Ahooja Phuangpaka Ungprasert Panorkwan Toparkngam Supajit Nawapun Wittawat Takong Ubonrat Toimamueang Sirirat Anutrakulchai |
author_facet | Eakalak Lukkanalikitkul Burabha Pussadhamma Anucha Ahooja Phuangpaka Ungprasert Panorkwan Toparkngam Supajit Nawapun Wittawat Takong Ubonrat Toimamueang Sirirat Anutrakulchai |
author_sort | Eakalak Lukkanalikitkul |
collection | DOAJ |
description | Background: Patency of vascular accesses (VA) is associated with left ventricular hypertrophy (LVH) in kidney transplant recipients (KTR). This level of VA flow (VAF) as related to LVH was assessed and an upward level of VA flow recommended for VA closure determined. This recommendation has not been previously reported. Methods: 123 KTR cohort patients were enrolled between August 2016 and December 2017 and their LVH and LV mass index (LVMI) by echocardiography and VAF by Doppler ultrasound were evaluated at baseline and for a 24-month follow-up period. Associations between VAF and LVH were adjusted for other factors. Results: Patients with patent VA (55.3%) had significantly greater LVH (47.1 vs. 29.1%, an adjusted odds ratio 2.44, p = 0.03) and LVMI (112.15 ± 34.4 vs. 97.55 ± 23.55 g/m2, p = 0.009) when compared with the non-VA group. A positive correlation between VAF rate and LVM was noted (r = 0.40, p < 0.001). Subgroup analysis revealed the VAF ≥ 900 ml/min had risks of LVH 3.61, and 2.86 times compared with the non-VA group and the VAF < 900 ml/min group. After a 24-month follow up, there was no significantly individual change in LVMI in patients with or without VA except 6 patients who lost their VA patency during follow-up time had a significant reduction of LVMI (120.17 ± 52.13 to 80.89 ± 22.72 g/m2, p = 0.046). Conclusions: Patency of VA in post-KT patients was associated with LVH. There was a significant reduction of LMVI after loss of VA patency. Patients with stable kidney graft function should be considered for VA closure especially if VAF is ≥ 900 ml/min. |
first_indexed | 2024-04-12T10:50:10Z |
format | Article |
id | doaj.art-a618cddb178b4e9ab8691cb776594b12 |
institution | Directory Open Access Journal |
issn | 2352-9067 |
language | English |
last_indexed | 2024-04-12T10:50:10Z |
publishDate | 2022-06-01 |
publisher | Elsevier |
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series | International Journal of Cardiology: Heart & Vasculature |
spelling | doaj.art-a618cddb178b4e9ab8691cb776594b122022-12-22T03:36:16ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672022-06-0140101048Effect and correlation of patent vascular access flow on left ventricular hypertrophy in kidney transplant patientsEakalak Lukkanalikitkul0Burabha Pussadhamma1Anucha Ahooja2Phuangpaka Ungprasert3Panorkwan Toparkngam4Supajit Nawapun5Wittawat Takong6Ubonrat Toimamueang7Sirirat Anutrakulchai8Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDepartment of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDepartment of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDepartment of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDivision of Nephrology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Division of Nursing, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDivision of Nephrology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Corresponding author at: Division of Nephrology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.Background: Patency of vascular accesses (VA) is associated with left ventricular hypertrophy (LVH) in kidney transplant recipients (KTR). This level of VA flow (VAF) as related to LVH was assessed and an upward level of VA flow recommended for VA closure determined. This recommendation has not been previously reported. Methods: 123 KTR cohort patients were enrolled between August 2016 and December 2017 and their LVH and LV mass index (LVMI) by echocardiography and VAF by Doppler ultrasound were evaluated at baseline and for a 24-month follow-up period. Associations between VAF and LVH were adjusted for other factors. Results: Patients with patent VA (55.3%) had significantly greater LVH (47.1 vs. 29.1%, an adjusted odds ratio 2.44, p = 0.03) and LVMI (112.15 ± 34.4 vs. 97.55 ± 23.55 g/m2, p = 0.009) when compared with the non-VA group. A positive correlation between VAF rate and LVM was noted (r = 0.40, p < 0.001). Subgroup analysis revealed the VAF ≥ 900 ml/min had risks of LVH 3.61, and 2.86 times compared with the non-VA group and the VAF < 900 ml/min group. After a 24-month follow up, there was no significantly individual change in LVMI in patients with or without VA except 6 patients who lost their VA patency during follow-up time had a significant reduction of LVMI (120.17 ± 52.13 to 80.89 ± 22.72 g/m2, p = 0.046). Conclusions: Patency of VA in post-KT patients was associated with LVH. There was a significant reduction of LMVI after loss of VA patency. Patients with stable kidney graft function should be considered for VA closure especially if VAF is ≥ 900 ml/min.http://www.sciencedirect.com/science/article/pii/S2352906722000975Access flow rateKidney transplantLeft ventricular hypertrophyVascular access |
spellingShingle | Eakalak Lukkanalikitkul Burabha Pussadhamma Anucha Ahooja Phuangpaka Ungprasert Panorkwan Toparkngam Supajit Nawapun Wittawat Takong Ubonrat Toimamueang Sirirat Anutrakulchai Effect and correlation of patent vascular access flow on left ventricular hypertrophy in kidney transplant patients International Journal of Cardiology: Heart & Vasculature Access flow rate Kidney transplant Left ventricular hypertrophy Vascular access |
title | Effect and correlation of patent vascular access flow on left ventricular hypertrophy in kidney transplant patients |
title_full | Effect and correlation of patent vascular access flow on left ventricular hypertrophy in kidney transplant patients |
title_fullStr | Effect and correlation of patent vascular access flow on left ventricular hypertrophy in kidney transplant patients |
title_full_unstemmed | Effect and correlation of patent vascular access flow on left ventricular hypertrophy in kidney transplant patients |
title_short | Effect and correlation of patent vascular access flow on left ventricular hypertrophy in kidney transplant patients |
title_sort | effect and correlation of patent vascular access flow on left ventricular hypertrophy in kidney transplant patients |
topic | Access flow rate Kidney transplant Left ventricular hypertrophy Vascular access |
url | http://www.sciencedirect.com/science/article/pii/S2352906722000975 |
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