SynthesisKidney & blood pressure research2026
Reversal of Uraemic Cardiomyopathy following Kidney Transplantation: Systematic Review and Meta-Analysis of Myocardial Strain Compared to Left Ventricular Volumetry as a Potential Early Marker.
Synthesis in Kidney & blood pressure research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAdverse cardiovascular changes associated with end-stage kidney disease (ESKD), referred to as uraemic cardiomyopathy, can potentially be reversed by kidney transplantation (KTx). Myocardial strain is hypothesized to be a more sensitive marker for reversal of uraemic cardiomyopathy following KTx than conventional left ventricle (LV) volumetric measurements. This meta-analysis study compared post-KTx changes in myocardial strain (global longitudinal strain [GLS], global circumferential strain [GCS], global radial strain [GRS]) and LV volumetry (left ventricular mass index [LVMi], left ventricular ejection fraction [LVEF], LV end-diastolic volume indexed [LVEDVi], and left ventricular end-systolic volume indexed [LVESVi]) measured by cardiac magnetic resonance (CMR) and echocardiography.
methodsA systematic search was performed on PubMed for articles published through November 2025. Studies meeting the inclusion criteria, assessing paired myocardial strain pre- and post-KTx in adult ESKD patients using echocardiography or CMR, were included in the meta-analysis.
resultsTen echocardiographic and three CMR studies were included, with follow-up durations ranging from 1 to 36 months. Strain measurements improved across all parameters, LV GLS (standardized mean difference [SMD] -1.57 [95% CI: -2.66, -0.48]; p = 0.005), LV GCS (SMD -1.63 [95% CI: -2.33, -0.93]; p < 0.00001) and LV GRS (SMD 3.34 [95% CI: 1.08, 5.59]; p = 0.004). Conventional LV volumetric measurements also improved, LVMi (SMD -17.93 [95% CI: -26.19, -9.68]; p < 0.0001), LVEF (SMD 5.45 [95% CI: 0.17, 10.72); p = 0.04), LVEDVi (SMD -12.72 [95% CI: -17.59, -7.84]; p < 0.00001), and LVESVi (SMD -8.79 [95% CI: -11.72, -5.86]; p < 0.00001).
conclusionThese findings indicate a reversal of uraemic cardiomyopathy following KTx. However, since both strain and volumetric measurements showed similar patterns of improvement across CMR and echocardiography, myocardial strain could not be confirmed as a more sensitive marker of uraemic cardiomyopathy reversal than LV volumetry.
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