Atrial changes after kidney transplant: what diagnostic and therapeutic perspectives?

Kidney transplant is known to be the first choice therapy for end-stage chronic kidney disease, also for its positive effects on kidney transplant recipients cardiovascular morbidity and mortality. Several evidences evaluated the morphological changes in the left ventricle before and after transplantation, demonstrating a positive effect of at least partial regression of left ventricular hypertrophy (LVH) in kidney transplant recipients. Atrial pathology is likewise important in determining kidney transplant recipients outcomes. In this issue, Regale et al. focused on atrial morphological changes after kidney transplant and found retrospectively that left atrium dilatation tends to progress over time, but the minority of patients that present a reduction after transplant in atrial diameter has a benefit in terms of mortality. These new acquisitions focus on atrial pathology that, probably also thanks to the contribution of circulating mediators such as natriuretic peptides, can significantly influence morbidity and mortality after transplant. The evaluation of the of natriuretic peptide changes before and after transplant and the use of new classes of drugs acting on the natriuretic peptides system are new interesting research areas.