The predictors of left ventricular hypertrophy in kidney transplant recipients

Background: Cardiovascular disease (CVD) is one of the leading causes of mortality among kidney transplant (KTx) recipients. Left ventricular hypertrophy (LVH) is a known important risk factor for CVD in KTx recipients. The current study aimed at evaluating the association of LVH with hypertension, carotid intima media thickness (CIMT), and serum biomarkers. Methods: The current cross sectional study included KTx recipients; ambulatory blood pressure monitoring, echocardiography, and CIMT measurement were performed. In addition to standard laboratory investigations, high sensitivity C-reactive protein (CRP) and serum homocysteine were measured. Results: A total of 30 KTx recipients (20 male, 10 female, mean age: 44.53 ± 13.59 years) were enrolled. One-third had diabetes and 73.3% hypertension. Their mean systolic and diastolic blood pressure (BP) was 132.0 ± 14.4 and 77.8 ± 11.3 mmHg, respectively. BP was well controlled, albeit with more antihypertensive agents of 1.5 (interquartile range (IQR): 0 - 4). Their baseline serum creatinine and eGFR were 108.3 (IQR: 66-319) μM/L and 69.8 ± 20.8 mL/min/1.73 m2, respectively. Seven patients had LVH and predominantly had diabetes, a higher pulse pressure, and elevated serum homocysteine. Predictors of left ventricular mass index (LVMI) were the incidence of diabetes, higher pulse pressure, serum homocysteine, and the number of antihypertensive agents prescribed. On multivariate analysis, diabetes and pulse pressure were the main predictors of left ventricular mass index. Conclusions: LVH is common in patients with KTx, especially in the ones with diabetes. Serum homocysteine is a surrogate marker for LVH.