Chronic kidney disease (CKD) is associated with a high risk of death and morbidity due to cardiovascular disease. Much of this is caused by left ventricular disease characterised by abnormal muscle thickness and scaring. This process appears to start early in the course of CKD and causes heart failure and dangerous abnormal heart rhythms. Previous work suggests that the process may be reversible by kidney transplantation but almost all of the studies are small, retrospective and lack scientific rigour. Furthermore, they almost all use echocardiography, which is inaccurate in patients with CKD. The investigators plan to perform the first large, prospective, controlled, blind-analysed study using cardiac magnetic resonance imaging to determine whether CKD associated cardiomyopathy is reversed by kidney transplantation and if so, whether factors such as blood pressure and mediators of metabolic bone disease/fibrosis are important in effecting this change. Greater understanding of the mechanisms responsible for CKD associated cardiomyopathy could lead to future strategies and treatments to improve the high cardiovascular mortality associated with this condition.
Study Type
OBSERVATIONAL
Enrollment
100
Cardiac Magnetic Resonance Imaging (Siemens Skyra 3T): will be performed using protocols and techniques already in use in our group. All CMR scan derived parameters will be analysed with the investigator blinded to treatment allocation as in previous studies.
Queen Elizabeth Hospital
Birmingham, West Midlands, United Kingdom
RECRUITINGLeft Ventricular Mass
Calculated by Cardiac MRI
Time frame: One year.
Native Myocardial T1 Times.
Measured using T1 mapping techniques (MOLLI)
Time frame: One year.
Blood Pressure
24hr Ambulatory Blood pressure monitoring
Time frame: One year.
Pulse Wave Analysis.
To calculate augmentation index as a marker of arterial stiffness.
Time frame: One Year
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