Kidney transplantation reduces left-ventricular mass index by 22 g/m² in end-stage kidney disease

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The American journal of the medical sciences Published June 1, 2026 Medically reviewed June 1, 2026 Study authors: Betsikos Achilleas, Theodorakopoulou Marieta P, Korogiannou Maria, Marinaki Smaragdi, Kamperidis Vas… PubMed ↗ DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Interpret LVMI reduction after kidney transplantation as associative, not causal, due to high heterogeneity and observational data.

This systematic review and meta-analysis of 33 observational studies including 2364 patients with end-stage kidney disease undergoing kidney transplantation assessed changes in left-ventricular mass index (LVMI) after transplantation. The primary outcome was LVMI change from pre-transplantation values. Overall, kidney transplantation was associated with a significant decrease in LVMI, with a weighted mean difference (WMD) of -21.99 g/m² (95% CI -28.10 to -15.87, P<0.00001), though heterogeneity was high (I²=89%). In a subgroup analysis of studies with follow-up ≤6 months (163 patients), the reduction was larger: WMD -41.54 g/m² (95% CI -51.31 to -31.78, I²=13%, P<0.001). For follow-up >6 months, the decrease was WMD -18.96 g/m² (95% CI -25.44 to -12.47, I²=89%, P<0.001). Subgroup analyses by donor type and pre-transplant dialysis modality also showed significant LVMI reductions, though with high heterogeneity. The authors did not report limitations, safety outcomes, or funding sources. Given the observational nature of included studies and high heterogeneity, these results should be interpreted cautiously. The findings support the potential cardiovascular benefit of kidney transplantation, but causality cannot be inferred.

Study Details

Study typeMeta analysis

Sample sizen = 163

EvidenceLevel 1

Follow-up6.0 mo

PublishedJun 2026

PMID41724266

View Original Abstract ↓

BACKGROUND: Cardiovascular disease is the leading cause of death in end-stage kidney disease and the chronic cardiomyopathy of chronic kidney disease contributes significantly to this. Kidney transplantation (KTx) is associated with improved survival compared to dialysis. This systematic review and meta-analysis (CRD42022371202) aimed to assess the changes in echocardiographic indices in patients before and following KTx. METHODS: The literature search involved PubMed, Web-of-Science and Scopus databases, manual search of article references and grey literature. The primary outcome measure was left-ventricular mass index (LVMI). RESULTS: Thirty-three studies with 2364 patients were included in the metanalysis for the primary outcome. LVMI was significantly decreased after KTx compared to pre-transplantation values [WMD -21.99 g/m, 95 %CI (-28.10, -15.87) I = 89 %, P < 0.00001]. In subgroup analyses, higher differences were evident among 6 studies (N = 163) evaluating LVMI≤6 months after KTx [WMD -41.54 g/m2, 95 %CI (-51.31, -31.78), I = 13 %, P < 0.001] and lower differences among 26 studies (N = 2095) evaluating LVMI >6 months after KTx [WMD -18.96 g/m2, 95 %CI (-25.44, -12.47), I2 = 89 %, P < 0.001]. In sensitivity analyses, patients receiving kidney from living kidney donors [(WMD; -76.90 g/m2, 95 %CI (-122.13, -31.67), I2 = 88 %, P < 0.001)] and those on hemodialysis before KTx [WMD;-33.76 g/m2, 95 %CI (-51.51, -16.00), I2 = 92 % P < 0.001] presented higher LVMI reductions following transplantation. CONCLUSIONS: KTx is associated with significant reductions in LVMI compared to the pre-transplantation levels. This could be another factor contributing to the lower cardiovascular risk observed after KTx compared to dialysis.