Structural and functional echocardiographic abnormalities in children pre- and post-kidney transplant in Cape Town, South Africa
| dc.contributor.advisor | Swanson,Lenise(MBChB) | |
| dc.contributor.advisor | McCulloch,Mignon (MBChB,PhD) | |
| dc.contributor.advisor | Nourse,Peter(MBChB,Phd) | |
| dc.contributor.advisor | Coetzee,Ashton (MBChB) | |
| dc.contributor.advisor | Morrow,Brenda M(PhD) | |
| dc.contributor.advisor | Reddy,Deveshni(MBChB) | |
| dc.contributor.author | Tadesse,Handsome | |
| dc.date.accessioned | 2025-08-12T16:59:48Z | |
| dc.date.available | 2025-08-12T16:59:48Z | |
| dc.date.issued | 2024 | |
| dc.description.abstract | Introduction: Cardiovascular manifestations of chronic kidney disease (CKD) include structural changes such as left ventricular hypertrophy (LVH) related to hypertension and fluid overload, vascular wall thickening, and calcification. There are also functional abnormalities such as systolic and diastolic dysfunction including - reduced ejection fraction (EF) and fractional shortening (FS), diastolic dysfunction, arrhythmias, and increased stiffness of vessels. The risk of these abnormalities worsens with a decreasing glomerular filtration rate (GFR). The best treatment for patients with kidney failure is kidney transplantation. Candidates are usually screened for cardiac abnormalities, and it is not uncommon to find echocardiographic abnormalities. It is important to study how patients with cardiac abnormalities on echocardiography (echo) do during and after kidney transplantation to optimize pre-transplant treatment, peri-transplant care, and short and long-term post-transplant care. Objectives: The objective of this study is to identify patients with KF who had structural and functional cardiac abnormalities on echo before kidney transplant and to determine whether these abnormalities improved or worsened post-transplant. Method: Single-center retrospective review of children with cardiac abnormalities on echo who had kidney transplants from 1st January 2018 to 31st Dec 2023 at Red Cross War Memorial Children’s Hospital (RCWMCH). Result: Thirty-two patients out of forty-three (74%) had echocardiographic screening within one year before kidney transplant. Out of these 15/32 (46.9%) had abnormal structural or functional echocardiographic findings before transplant. Of the abnormal echocardiography, left ventricular systolic and diastolic constitute 6/32 (19%) while 3/15(9%) had left ventricular hypertrophy. During the study period, a total of 5 patients died after transplant (11.6%). There was no significant difference in independent variables between survivors and those who died (P value>0.05). There was no significant difference between ejection fraction (p = 0.5) or shortening fraction (p = 0.4) pre- to post-transplant, in those who had paired samples (n=6) [using Wilcoxon signed rank test]. Similarly, there was no association between pre-transplant ejection fraction or fractional shortening and immediate graft functioning or graft rejection (p > 0.1). Conclusion: Our study showed that close to half of patients who had echocardiographic screening had abnormality. Left ventricular systolic and diastolic dysfunction were the more common compared to left ventricular hypertrophy.There was no significant difference between ejection fraction and fractional shortening on echocardiographic evaluation pre and post-transplant among 6 patients who had paired pre and post-transplant echocardiographic study. | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/6353 | |
| dc.language.iso | en_US | |
| dc.publisher | Addis Ababa University | |
| dc.subject | Structural and functional cardiac abnormalities | |
| dc.subject | kidney transplant | |
| dc.title | Structural and functional echocardiographic abnormalities in children pre- and post-kidney transplant in Cape Town, South Africa | |
| dc.type | Thesis |