Effects of arteriovenous fistula on clinical, laboratory and echocardiographic findings in renal allograft recipients

Purpose: Left ventricular hypertrophy (LVH) is frequently observed in patients with end-stage renal disease and renal allograft recipients, and is an independent and strong predictor of morbidity and mortality. Presence of a patent arteriovenous fistula (AVF) after renal transplantation may contribute to the persistent LVH. We investigated the clinical, laboratory, and echocardiographic findings in patients with renal transplants with or without AVF. Methods: A total of 130 renal transplant recipients were included in this study: 60 hemodialysis patients whose fistulas were still functional, 49 hemodialysis patients whose fistulas were spontaneous stopped or closed, and 21 peritoneal dialysis patients who had never had fistulas created. Laboratory parameters were measured and echocardiographic measurements were performed. Results: There were no significant differences regarding smoking status, blood pressures, or NT-proBNP, hs-CRP, iPTH, and TSH levels between the study groups. Left atrial, right atrial diameters, left ventricle end-diastolic diameter, left ventricle end-systolic diameter, interventricular septum thickness (IVST), left ventricle mass index (LVMI), pulmonary artery pressure (PAP), and ejection fraction were similar in the three groups. In correlation analysis, PAP was significantly correlated with serum uric acid and NT-proBNP levels. Also, there were positive and moderate correlations between the serum uric acid and the IVST. Conclusion: Patent AVFs have not affected cardiovascular abnormalities such as LVH and LV mass index in patients with renal transplant. Hyperuricemia may be associated with increased PAP and high LVMI.