Left Atrial Diameter and Survival among Renal Allograft

Summary Background and objectives Sequential echocardiography is routinely performed in patients with ESRD listed for transplantation.Thebenefitofthislabor-andtime-intensivemeasure,however,remainsunclear.Thus,thisstudy elucidated the various obtained routine echocardiography parameters that best predicted mortality and graft survival after renal transplantation. Design,setting,participants,m 95% confidence interval, 1.03 to 1.08; P,0.001) and cause-specific cardiac death (hazard ratio, 1.04; 95% confidence interval, 1.00 to 1.08; P=0.04). Functionalgraftlosswaspredictedbytherightatrialdiameter(hazardratio,1.04;95%confidenceinterval,1.02to 1.07; P=0.001). Conclusion The left atrial diameter determined at transplantation predicted overall and cardiac mortality. Patients with widely enlarged left atria exhibit a considerably reduced life expectancy. It remains to be determined, however, whether renal transplantation is futile in these patients. Clin J Am Soc Nephrol 8: 2100–2105, 2013. doi: 10.2215/CJN.04300413