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End-stage renal disease and dilated cardiomyopathy: A retrospective analysis in renal transplant patients

 Department of Anesthesiology, Critical Care and Pain Management, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India

Correspondence Address:
Vishnu Kumar Garg,
Department of Anesthesiology, Critical Care and Pain Management, Mahatma Gandhi Medical College and Hospital, Sitapura, Jaipur - 302 022, Rajasthan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_563_21

Background: End-stage renal disease is the last stage of progressive renal failure that is almost always accompanied by cardiovascular complications such as systemic and/or pulmonary hypertension, atherosclerosis, dilated cardiomyopathy (DCM), valvular regurgitation, and so on. Among these, DCM is a common preoperative echocardiographic finding that necessitates specialized treatment. Materials and Methods: Patients with DCM who underwent renal transplantation using an intraoperative goal-directed strategy for fluids, inotropes, and vasopressors were included in this retrospective study. The demographics of the patients, their preoperative comorbidities, investigations, echocardiographic data, intraoperative parameters, and postoperative data and complications were all recorded and analyzed. Results: Hypotension was the most common intraoperative complication in 10 out of 22 patients (95% confidence interval: 0.24–0.66). There were no other major cardiopulmonary complications in any of the patients. There were no renal complications, such as delayed graft function or acute tubular necrosis, in any of the patients. Conclusions: Fluids, inotropes, and vasopressors must all be managed carefully during the perioperative period in DCM patients. The use of advanced dynamic indices is critical not only for achieving goals but also for avoiding complications.

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