Angioaccess in renal transplant recipients. Quandaries in the light of type 4 cardiorenal syndrome

Abstract

Introduction: Cardiovascular complications have become the leading cause of morbidity and mortality in patients with chronic kidney disease and renal transplantation. Objective: To determine the repercussions of surgical closure of the angioaccess on clinical, laboratory, and echocardiographic variables in renal transplant recipients. Material and Methods: Quasi-experimental study consisting of two groups of patients. Clinical, laboratory, and echocardiographic variables were comparatively analyzed. Results: A total of 101 patients were included: group 1 (experimental), with vascular access closure (n=49); and group 2 (comparison), without angioaccess closure (n=52), with mean ages of 46.16 and 44.85 years, respectively, and predominantly male. In the experimental group, clinical manifestations, blood pressure control, heart rate (p<0.05), hematocrit (p>0.05), and serum creatinine (p<0.05) improved compared with group 2. The alterations found in the variables measured by echocardiography showed no association with the location of the angioaccesses (p>0.05). The mean values of the differences (final - initial) in five variables located in the left wrist showed improvement. The left ventricular ejection fraction increased in the experimental group. The left ventricular diameter in diastole, interventricular septum thickness, and left ventricular mass index showed statistical significance (p<0.05). The variables determined in the left elbow fold exhibited statistically significant intergroup differences (p<0.05). Conclusion: The surgical closure of the angioaccess has repercussions on clinical, laboratory, morphological, and hemodynamic variables of the cardiovascular system, which are related to the renocardiac syndrome.