NT-proBNP plasma levels and echocardiographic assessment of cardiac function in patients after renal transplantation

Background: Cardiovascular diseases are the most important causes of death in patients with chronic renal disease (CRD). Successful renal transplantation (RTx) corrects water and electrolyte disturbances and decreases or eliminates anaemia it favourably influences cardiac haemodynamics and reduces risk of cardiovascular events. NT-proBNP plasma concentration is one of the prognostic and risk factors in such cases, whereas echocardiography that enables evaluation of the left atrium and ventricle allows detailed analysis of haemodynamic condition of the heart. Aim: To analyse NT-proBNP plasma concentration and selected echocardiographic parameters in patients after RTx at various time intervals after the procedure. Methods: Seventeen patients after RTx were included in the study (age 46.5 +/- 16 years, 7 men and 10 women). NT-proBNP plasma level measurements and echocardiography were performed immediately before and at 3 and 6 months after RTx. Additionally, these parameters were assessed in patients receiving cyclosporine A (CsA) and tacrolimus (TAC). Results: NT-proBNP plasma level decreases significantly after RTx (initially 4369 +/- 2420, at 3 months 2056 +/- 576, at 6 months 1580 +/- 572 pg/ml). In the TAC group, a significant reduction was observed at 3 months (from 13291 +/- 3563 to 1845 +/- 1022 pg/ml). In patients treated with CsA reduction occurred at 6 months after RTx (from 9447 +/- 3369 to 1246 +/- 436 pg/ml). At six-month follow-up significant changes in ejection fraction were not found. However, a significant increase in LV mass in CsA patients was observed. Conclusions: Reduction of NT-proBNP levels seems to be more the result of transplanted kidney function than of an improvement in circulation. Significant LV mass increase in CsA patients may be a result of higher blood pressure levels observed before and after RTx.