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Revista de Nefrología, Diálisis y Trasplante

ISSN 0326-3428 (Print)
Órgano de difusión científica de la Asociación Nefrológica de Buenos Aires
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2023, Number 4

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Rev Nefrol Dial Traspl 2023; 43 (4)

Angioaccess in renal transplant recipients. Quandaries in the light of type 4 cardiorenal syndrome

Cruz ARE, Ramírez GJI, Gutiérrez GC, Barreto FEE, Hernández FME, González CY
Full text How to cite this article

Language: Spanish
References: 25
Page: 208-218
PDF size: 274.84 Kb.


Key words:

Renal transplantation, arteriovenous fistula closure, echocardiographic variables.

ABSTRACT

Introduction: Cardiovascular complications have become the leading cause of morbidity and mortality in patients with chronic kidney disease and renal transplantation. Objective: To determine the repercussions of surgical closure of the angioaccess on clinical, laboratory, and echocardiographic variables in renal transplant recipients. Material and Methods: Quasi-experimental study consisting of two groups of patients. Clinical, laboratory, and echocardiographic variables were comparatively analyzed. Results: A total of 101 patients were included: group 1 (experimental), with vascular access closure (n=49); and group 2 (comparison), without angioaccess closure (n=52), with mean ages of 46.16 and 44.85 years, respectively, and predominantly male. In the experimental group, clinical manifestations, blood pressure control, heart rate (p‹0.05), hematocrit (p›0.05), and serum creatinine (p‹0.05) improved compared with group 2. The alterations found in the variables measured by echocardiography showed no association with the location of the angioaccesses (p›0.05). The mean values of the differences (final - initial) in five variables located in the left wrist showed improvement. The left ventricular ejection fraction increased in the experimental group. The left ventricular diameter in diastole, interventricular septum thickness, and left ventricular mass index showed statistical significance (p‹0.05). The variables determined in the left elbow fold exhibited statistically significant intergroup differences (p‹0.05). Conclusion: The surgical closure of the angioaccess has repercussions on clinical, laboratory, morphological, and hemodynamic variables of the cardiovascular system, which are related to the renocardiac syndrome.


REFERENCES

  1. Gulmez O. Cardiovascular evaluation of renal transplantrecipients. J Clin Exp Cardiolog. 2017;8(9):1-5.

  2. Celtik A, Alpay N, Celik A, Sezer TO, Turkmen A,Camsari T, Toz H, Sever MS, Hoscoskun C; TurkishSociety of Nephrology Kidney TransplantationWorking Group. Kidney transplant recipients withfunctioning grafts for more than 15 years. TransplantProc. 2013;45(3):904-7.

  3. Alprecht P, Zúñiga B, Lara JJ, Cáceres SV, Duarte YC.Effects of renal transplantation on cardiac morphologyand function Luís Vernaza Hospital, Guayaquil,Ecuador: Kidney transplant and morphology andcardiac function. Cardiovascular Diseases & Diagnosis.2020;1(1):2-6.

  4. Ronco C, Mc Cullough P, Anker SD, Anand I,Aspromonte N, Bagshaw SM, et al. Cardiorenalsyndromes: report from the consensus conferenceof the acute dialysis quality initiative. Eur Heart J.2010;31(6):703-11.

  5. Bright R. Cases and observations illustrative of renaldisease accompanied by the secretion of albuminousurine. Guys Hospital Reports. 1836;338-400.

  6. Bagshaw SM, Cruz DN, Aspromonte N, DalientoL, Ronco F, Sheinfeld G,et al. Epidemiology ofcardiorrenalsyndromes: workgroup statements fromthe 7th ADQI Consensus Conference. Nephrol DialTransplant. 2010;25(5):1406-16.

  7. House AA. Cardiorrenal syndrometype 4: epidemiology,pathophysiology and treatment. Semin Nephrol.2012;32(1):40-8.

  8. Ronco C, House AA, Haapio M. Cardiorenal andrenocardiac syndromes: the need for a comprehensiveclassification and consensus. Nature Clinical PracticeNephrology. 2008;4(6):310-1.

  9. Devine PA, Courtney AE, Maxwell AP. Cardiovascularrisk in renal transplant recipients. Journal of Nephrology.2019:32:389-99.

  10. Ayora AS, Alonso A, Pérez D, Ramírez JI, Cruz RE.Manifestaciones cardiovasculares en pacientes tratadoscon hemodiálisis periódica por fistula arteriovenosafuncional. CorSalud. 2016; 8(2):102-10.

  11. Cruz RE, Ramírez JI, González Y, Hernández ME,Hernández OA, Batista R. Repercusión hemodinámicadel cierre de la fistula arteriovenosa sobre el corazónderecho en trasplantados renales. Revista Cubana deMedicina. 2020;59 (3): e1371.

  12. Samarendra P, Ramkumar M, Sharma V, Kumari S.Cardiorenal syndrome in renal transplant recipients- It′s the fistula fault: A case series. Clin Transplant.2018;32(11): e13417.

  13. Cruz RE, Ramírez JI, Gutiérrez C, Batista R, HernándezME, Barreto EE. Angioaccesos para hemodiálisis en eltrasplante renal: Implicaciones hemodinámicas sobre elcorazón izquierdo. International Journal of Medical andSurgical Sciences. 2021;8(1):1-13.

  14. Reddy YNV, Obokata M, Dean PG, Nath KA,Borlaug BA. Long term cardiovascular changesfollowing creation of arteriovenous fistula in patientswith end stage renal disease. European Heart Journal.2017;38:1913-23.

  15. Dundon BK, Torpey K, Nelson AJ, Wong DTL,Duncan RF, Meredith IT, et al. The deleterious effectsof arteriovenous fistula-creation on the cardiovascularsystem: a longitudinal magnetic resonance imagingstudy. International Journal of Nephrology andRenovascular Disease. 2014; 7:337-45.

  16. Alkhouli M, Sandhu P, Boobes K, Hatahet K, RazaF, Boobes Y. Cardiac complications of arteriovenousfistulas in patients with end-stage renal disease.Nefrologia. 2015;35(3):234-45.

  17. Papasotiriou M, Xanthopoulou I, Ntrinias T,Kalliakmani P, Koutsogiannis N, Davlouros P, et al.Impact of arteriovenous fistula on cardiac size andfunction in kidney transplant recipients: A retrospectiveevaluation of 5-year echocardiographic outcome.ExpClin Transplant. 2019;17(5):619-26.

  18. Rao NN, Stokes MB, Rajwani A, Ullah S, WilliamsK, King D, et al. Effects of arteriovenous fistula ligationon cardiac structure and function in kidney transplantrecipients. Circulation. 2019; 139:2809-18.

  19. Wasse H, Singapuri MS. High-output heart failure:how to define it, when to treat it, and how to treat it.Semin Nephrol. 2012 Nov;32(6):551-7

  20. Zheng H, Bu S, Song Y, Wang M, Wu J,Chen J. Toligate or not to ligate: A meta-analysis of cardiac effectsand allograft function following arteriovenous fistulaclosure in renal transplant recipients. Ann Vasc Surg.2020; 63:287-92.

  21. Santoro D, Savica V, Bellinghieri G. Vascular accessfor hemodialysis and cardiovascular complications. TheItalian Journal of Urology and Nephrology [Minerva UrolNefrol] 2010; 62(1):81-5.

  22. Basile C, Vernaglione L, Casucci F, Libutti P,Lisi P, Rossi L, et al. The impact of haemodialysisarteriovenous fistula on haemodynamic parameters ofthe cardiovascular system. Clin Kidney J. 2016;9(5):729-34.

  23. Soleimani MJ, Shahrokh H, Shadpour P, Shirani M,Arasteh S. Impact of dialysis access fistula on cardiacfunction after kidney transplantation. Iranian Journalof Kidney Diseases. 2012;6(3):198-202.

  24. Stoumpos S, Mark PB. Should we ligate arteriovenousfistulas in asymptomatic patients after kidneytransplantation? Circulation. 2019;139(25):2819-21.

  25. McCullough PA, Rios A, Smith B. Dialysis fistulas andheart failure. European Heart Journal. 2017; 38:1924-5.




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Rev Nefrol Dial Traspl. 2023;43