Richard K. Burt, MD; Shalina Gupta-Burt, MD; Wadi N. Suki, MD; Camilo G. Barcenas, MD; James J. Ferguson, MD; Charles T. Van Buren, MD
We report the cases of four patients with end-stage renal disease and New York Heart Association class III or IV heart failure of nonischemic origin as documented by coronary angiography. Because of left ventricular dysfunction (left ventricular end-diastolic pressure, 23 to 30 mm Hg; ejection fraction, 20% to 35%), all four patients were initially considered poor surgical candidates for renal transplantation. These same four patients became asymptomatic, however, with markedly improved cardiac function (ejection fraction, 43% to 69%) detected as early as 6 and 14 days after renal engraftment. Therefore, there exists a subset of patients with end-stage renal disease in whom congestive heart failure should not be considered a contraindication to renal transplantation. We conclude that some dialysis-dependent patients who manifest symptomatic heart failure of nonischemic origin have a reversible cardiomyopathy and should not be denied renal transplantation.
Burt RK, Gupta-Burt S, Suki WN, Barcenas CG, Ferguson JJ, Van Buren CT. Reversal of Left Ventricular Dysfunction after Renal Transplantation. Ann Intern Med. ;111:635–640. doi: 10.7326/0003-4819-111-8-635
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Published: Ann Intern Med. 1989;111(8):635-640.
Nephrology, Renal Replacement Therapy.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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