Effects of a reduction in GFR on cardiovascular structure and function: a five year follow up study

Price, Anna Marie ORCID: 0000-0003-0952-7688 (2021). Effects of a reduction in GFR on cardiovascular structure and function: a five year follow up study. University of Birmingham. Ph.D.

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Abstract

The inverse association between glomerular filtration rate (GFR) and cardiovascular risk is well recognised but not fully explained. Furthermore, chronic kidney disease is associated with atherosclerosis, arteriosclerosis, left ventricular hypertrophy and myocardial fibrosis. Kidney donation reduces renal function by approximately 30% and allows the study of the cardiovascular effects of a reduced GFR in healthy subjects without confounding comorbidities.

This thesis aims to examine the isolated effects of a reduction in GFR as a result of nephrectomy on haemodynamics, blood pressure, cardiovascular structure and function, myocardial tissue characterisation and blood biomarkers.

In a multi-centre prospective controlled study, there were no significant changes in peripheral blood pressure or pulse wave velocity in donors compared to controls at 12 months. In a prospective 5 year longitudinal study of donors and controls, no significant differences were observed in left ventricular volumes or mass, strain parameters or ejection fraction at 5 years after nephrectomy. In a cross-sectional comparison of 1:1 age and sex matched donors and controls there were no significant differences in T1 or T2 times, extracellular volume or late gadolinium enhancement.

The reduction in GFR after donation does not lead to deleterious changes in cardiovascular structure and function at 5 years.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):