Cardiac Testing for Coronary Artery Disease in Potential Kidney Transplant Recipients: A Systematic Review of Test Accuracy Studies

Wang, Louis W.; Fahim, Magid; Hayen, Andrew; Mitchell, R.; Lord, Sue; Baines, Laura; Craig, Jonathan C.; Webster, Angela C

doi:10.1053/j.ajkd.2010.11.018

Cited by 76 publications

(48 citation statements)

References 46 publications

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“…Although the accuracy of dobutamine stress echocardiogram and SPECT in detecting obstructive CAD (≥70% stenosis) in renal transplantation candidates was not statistically different in a meta‐analysis,33 the presence of concentric and eccentric LVH, common in ESRD, may affect the accuracy of dobutamine stress echocardiogram 34. PET imaging assesses not only myocardial blood flow but also coronary flow reserve, which can provide additional insights into early stages of atherosclerosis and microvascular dysfunction 35, 36.…”

Section: Cad In Patients With Esrdmentioning

confidence: 99%

Diagnosis and Management of Cardiovascular Disease in Advanced and End‐Stage Renal Disease

Bhatti

Galougahi

Paz

et al. 2016

JAHA

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Section: Cad In Patients With Esrdmentioning

confidence: 99%

Diagnosis and Management of Cardiovascular Disease in Advanced and End‐Stage Renal Disease

Bhatti

Galougahi

Paz

et al. 2016

JAHA

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“…In the literature, increases in cardiomyopathy, valvular lesions, calcified vein diseases, and peripheral vascular diseases with hypertension are reported in kidney, pancreas, or kidney and pancreas transplant recipients. 5 Cardiovascular diseases are responsible for approximately 30% of deaths after renal transplants; 40% of these are within 3 months. 6,7 Aortic dissection develops in only 2 patients/month after a successful renal transplant, and cardiovascular surgeries generally are done at a later time.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Uçar

Erdil²,

Şanlı³

et al. 2016

Exp Clin Transplant

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Kidney transplant is a last resort to increase the life expectancy and quality of life in patients with renal failure. Aortic dissection is a disease that requires emergency intervention; it is characterized by sudden life-threatening back or abdominal pain. In the case described, constant chest pain that increased with respiration was present on exam-ination of a 28-yearold man (85 kg, 173 cm) who presented at our emergency department complaining of severe back pain. He had undergone a kidney transplant in 2004 from his mother (live donor). He was diagnosed with acute Type II aortic dissection and was scheduled for emergent surgery. Because there were no surgical or anesthetic complications, the patient with 79 and 89 minutes aortic cross-clamping and cardiopulmonary bypass durations was sent, intubated, to intensive care unit. When nephrotoxic agents are avoided and blood flow is stabilized, cardiovascular surgery with cardiopulmonary bypass may be performed seamlessly in patients who have undergone a kidney transplant.

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“…The best available data are from a meta-analysis by Wang et al [8]. The authors identified that MPS (sensitivity 0.69, specificity 0.77) and dobutamine stress echocardiography (sensitivity 0.80, specificity 0.89) had the best test performance amongst the modalities studied, including stress electrocardiography, digital subtraction fluorography, and exercise ventriculography; the difference between MPS and dobutamine stress echocardiography did not meet statistical significance (p = 0.07).…”

Section: Screening Domainmentioning

confidence: 99%

Detection of Atherosclerotic Cardiovascular Disease in Patients with Advanced Chronic Kidney Disease in the Cardiology and Nephrology Communities

et al. 2018

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Background: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality among patients with chronic kidney disease (CKD) with a glomerular filtration rate of < 60 mL/min/1.73 m² body surface area. The availability of high-quality randomized controlled trial data to guide management for the population with CKD and ASCVD is limited. Understanding current practice patterns among providers caring for individuals with CKD and CVD is important in guiding future trial questions. Methods: A qualitative survey study was performed. An electronic survey regarding the diagnosis and management of CVD in patients with CKD was conducted using a convenience sample of 450 practicing nephrology and cardiology providers. The survey was administered using Qualtrics® (https://www.qualtrics.com). Results: There were a total of 113 responses, 81 of which were complete responses. More than 90% of the respondents acknowledged the importance of CVD as a cause of morbidity and mortality in patients with CKD. Outside the kidney transplant evaluation setting, 5% of the respondents would screen an asymptomatic patient with advanced CKD for ASCVD. Outside the kidney transplant evaluation scenario, the respondents did not opt for invasive management strategies in advanced CKD. Conclusions: The survey results reveal a lack of consensus among providers caring for patients with advanced CKD about the management of ASCVD in this setting. Future randomized controlled trials will be needed to better inform the clinical management of ASCVD in these patients. The limitations of the study include its small sample size and the relatively low response rate among the respondents.

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Cardiac Testing for Coronary Artery Disease in Potential Kidney Transplant Recipients: A Systematic Review of Test Accuracy Studies

Cited by 76 publications

References 46 publications

Diagnosis and Management of Cardiovascular Disease in Advanced and End‐Stage Renal Disease

Diagnosis and Management of Cardiovascular Disease in Advanced and End‐Stage Renal Disease

Untitled

Detection of Atherosclerotic Cardiovascular Disease in Patients with Advanced Chronic Kidney Disease in the Cardiology and Nephrology Communities

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