Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.110628
Revised: July 30, 2025
Accepted: November 11, 2025
Published online: March 18, 2026
Processing time: 208 Days and 12.7 Hours
An echocardiogram is an essential tool in the evaluation of potential kidney transplant recipients (KTRs). Despite cardiac clearance, potential KTRs still have structural and functional abnormalities. Identifying the prevalence of these abnormalities and understanding their predictors is vital for optimizing pre-transplant risk stratification and improving post-transplant outcomes.
To determine the prevalence of left ventricular hypertrophy (LVH), left ventri
The study included all successful transplant candidates older than 14 who had a baseline echocardiogram. Binary logistic regression models were constructed to identify factors associated with LVH, LVSD, DD, and PH.
Out of 259 patients, LVH was present in 64% (166), 12% (31) had LVSD, 27.5% (71) had DD, and 66 (25.5%) had PH. Independent predictors of LVH included male gender [odds ratio (OR): 2.51; 95%CI: 1.17–5.41 P = 0.02], PH (OR = 2.07; 95%CI: 1.11–3.86; P = 0.02), DD (OR: 2.47; 95%CI: 1.29–4.73; P = 0.006), and dyslipidemia (OR = 1.94; 95%CI: 1.07–3.53; P = 0.03). Predictors for LVSD included patients with DD (OR = 3.3, 95% CI: 1.41–7.81; P = 0.006) and a family history of coronary artery disease (OR = 4.50, 95%CI: 1.33–15.20; P = 0.015). Peritoneal dialysis was an independent predictor for DD (OR = 10.03; 95%CI: 1.71-58.94, P = 0.011). The presence of LVH (OR = 3.32, 95%CI: 1.05–10.55, P = 0.04) and mild to moderate or moderate to severe mitral regurgitation (OR = 4.63, 95%CI: 1.45–14.78, P = 0.01) were significant factors associated with PH. These abnormalities had no significant impact on estimated glomerular filtration at discharge, 6 months, 1 year, or 2 years post-transplant.
Significant echocardiographic abnormalities persist in a potential transplant candidate despite cardiac clearance, although they don’t affect future graft function. Understanding the risk factors associated with these abnormalities may help clinicians address these factors pre- and post-transplant to achieve better outcomes.
Core Tip: Despite clearance by a cardiologist, kidney transplant recipients have structural and functional abnormalities. These abnormalities may partially resolve after transplantation, but not wholly. Abnormalities such as left ventricular hypertrophy, left ventricular systolic dysfunction, diastolic dysfunction, pulmonary hypertension may have an impact on graft and patient survival. Understanding their predictors may help alleviate these abnormalities and improve patient and graft survival. This will enable clinicians to devise a pathway to reduce cardiovascular events, improve long-term graft function, and decrease mortality.