Effect of successful renal transplantation on coronary AGE accumulation of uremic heart

摘要

In order to investigate the effect of successful renal transplantation (RTx) on uremic heart, we examined (1) imrnunohistochemical AGE (CML-AGE) accumulation on cardiac arterial walls from well-functioning RTx patients (n = 8), patients on maintenance dialysis (DY) (n= 10) and nondiabetic subjects with normal renal function as control (n = 7), and (2) the changes in cardiovascular functions before and after RTx. Results: (1) Coronary atherosclerotic lesions were detected in both DY and RTx patients (diffuse intimal thickenings of all patients and partial fatty streaks of two DY patients). (2) In 9 of 10 DY patients, AGE accumulation was observed in coronary arteries (intima or media), although this was true in only two of seven control subjects (p < 0.05). In five DY patients, strongly positive AGE staining was observed in intramyocardial arterioles. On the other hand, the degree and incidence of AGE accumulation of cardiac tissues of RTx patients were significantly lower, especially in media of the coronary arteries, than DY patients. (3) On echocardiogram, decreases in LVDci, LVDs and LVPwTd, and increases in FS and EF were significantly observed. Conclusion: successful and well-functioning RTx significantly improved cardiovascular functions of long-term DY patients. Significant decrease in AGE accumulation in cardiovascular walls can participate in the improvement, together with ameliorations of anemia,blood pressure and renal function.