Effects of a Reduction in Kidney Function on Cardiovascular Structure and Function: A Prospective Study of Kidney Donors

University Hospital Birmingham NHS Foundation Trust124 enrolled

Overview

Studies of patients with established kidney disease, even when this is mild, appear to show that they are at high risk of heart failure, stroke and sudden cardiac death. This may be because kidney disease causes stiffening of the arteries in the body which means that the heart and brain are damaged by high blood pressure. By studying patients before and after the removal of a kidney (uni-nephrectomy) for transplantation the investigators will find out for the first time in man the effect of an isolated reduction in kidney function on the structure and function of the arteries and heart. Hypotheses. An isolated reduction in GFR occuring after surgical uni-nephrectomy is associated with long term adverse cardiac and vascular effects which include: 1. Increased arterial stiffness and left ventricular mass 2. Abnormalities in left ventricular systolic and diastolic function 3. Increased oxidative stress, inflammation and collagen turnover

Study Type

OBSERVATIONAL

Enrollment

124

Conditions

Chronic Kidney Disease

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Potential kidney donor attending University Hospital Birmingham NHS Foundation Trust Current nationally set Exclusion Criteria: * Diabetes mellitus * Atrial fibrillation * Left ventricular dysfunction (ejection fraction \<40% on transthoracic echocardiography) * History of cardiovascular or pulmonary disease * Evidence of hypertensive end-organ damage.

Locations (1)

Outcomes

Primary Outcomes

Left ventricular mass as measured by CMR and Echocardiography

Time frame: 3 years

Arterial stiffness as measured by pulse wave velocity

Time frame: 3 years

Secondary Outcomes

Aortic compliance measured by cardiac magnetic resonance imaging

Time frame: 3 years

Left ventricular systolic and diastolic elastance measured by echocardiography;

Time frame: 3 years

Oxidative stress, inflammation and collagen turnover measured by blood assays of plasma renin, aldosterone, high sensitivity C-reactive protein (hsCRP), procollagen type III aminoterminal peptide (PIIINP) and C-telopeptide for type I collagen (CITP).

Time frame: 3 years