Background: Hypertension (HT) and renal anaemia (RA) are well-established markers of cardiovascular risk in patients with chronic kidney disease (CKD). They appear to be the stimuli for left ventricular hypertrophy (LVH), who significantly participates in cardiac complications in uremic patients. Hypertension is extremely common after kidney transplantation (KTx) and it has been observed in up to 75% of patients. The prevalence of post-renal transplant anaemia (PTA) is variable (up to 30%) and several factors such as graft function contribute towards its pathophysiology. Aim: The aim of this study was to analyze the impact of blood pressure and anaemia on LV remodelling in first year after transplantation comparing echocardiographic findings before and twelve months after transplantation had done. Methods: In five years retrospective-prospective study we followed up 30 patients with renal allograft in first post-transplant year. During the study values of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), blood hemoglobin (Hgb), serum creatinine and creatinine clearance were monitored monthly. Results: Before transplantation (Tx) 86% of patients had HT, and RA was confirmed in all patients. Normal echocardiographic findings had 33% of patients and 67% of patients had echocardiographic sings of LVH. Before renal transplantation group with LVH had statistically higher the mean values of blood pressure (MBP) (p=0.053) compared to group with diastolic (LVDDF) (p=0.0047) and systolic-diastolic dysfunction (LVSDDF) (p=0.0046). The values of SBP and DBP positively correlated with LV mass index (LVMI) in the group of patients with LVH (p=0.0007 and p=0.0142). The values of Hgb was statistically higher in group with normal LV mass index compared to LVH (p=0.019), with negative correlation between LVMI and values of Hgb in the patients group with LV hypertrophy (p=0.009). After the first year of transplantation, 63% of patients showed normal LV mass index and 37% remained with echocardiographic findings of the LVH. The values of SBP and values of Hgb in both groups, as well as values of DBP in group of LVH were statistically different in compare with data before transplantation (p<0.05). The positive echocardiographic remodelling of LV significantly correlated with the increase of Hgb values (p=0.05), but without significant correlation with the decrease of the mean SBP and DBP. Conclusion: These results confirmed that positive echocardiographic remodelling of left ventricle after successful renal transplantation is complex process depended on many risk factors and elimination of uremia- related factors is a priority.

Aim of kidney transplantation is to keep the functions of graft as long as possible, with an improvement of survival and quality of patients' lives. Aim of this article was to show the outcome of kidney transplantation in patients who were treated and monitored on Institute of Nephrology, CCU of Sarajevo in period between 1996 and 2004. and to identify the factors which can interfere with graft surviving. Retrospective analysis of data from the register of kidney transplanted patients was done. In the mentioned period 29 kidney transplants were performed, and at the same time 15 previously transplanted patients (total of 44) were monitored. Patients were followed until death or graft insufficiency. Most often cause of chronic renal failure before the transplantation were glomerular diseases (31.8% cases), and chronic pyelonephritis in 29.5% cases. Living-donor related kidney transplantation was performed in 56,8% of patients, living-donor unrelated in 27,3% of patients and cadaveric in 15.9% of patients. Post-transplant complications occurred in 29,5% of patients. Analysis of graft surviving on 12 months, 5 years and 10 years monitoring showed functional grafts in 87.5%, 80% and 75.0% of patients. Cumulative survival of patients on one year monitoring is 100%, on 5 year 100%, and on 10 year 93.8%. Primary causes of graft function loss were recurrent kidney diseases. Three patients (6.8%) died due to concomitant diseases, irrespective of the transplantation. Kidney transplantation is a successful treatment of a chronic renal failure with a high percentage of patients survival and long term graft survival, but also with serious post-transplant complications.