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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Predictors of coronary disease in patients with end stage renal disease

K Varghese1, G Cherian, U T Abraham

  • 1Department of Cardiology, Chest Diseases Hospital, Safat, Kuwait.

Renal Failure
|January 5, 2002
PubMed

Insights

For patients with end-stage renal disease awaiting kidney transplants, increasing age and a family history of early heart disease predict significant coronary artery disease (CAD). Certain non-invasive markers also proved useful in identifying CAD risk.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • End-stage renal disease (ESRD) patients exhibit a high prevalence of cardiovascular disease (CVD).
  • Coronary arteriography is frequently performed before kidney transplantation.
  • The utility of traditional risk factors and non-invasive markers for identifying coronary artery disease (CAD) in ESRD patients needs further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of conventional risk factors and non-invasive markers in predicting significant coronary artery disease (CAD) in patients with end-stage renal disease (ESRD).
  • To determine which factors best identify patients requiring coronary arteriography prior to kidney transplantation.

Main Methods:

  • A cohort of 116 patients with ESRD underwent coronary arteriography.
  • Coronary artery disease (CAD) was defined as significant lesions causing >= 50% luminal diameter stenosis.
  • Patient data included age, family history, symptoms (angina), ECG findings (abnormal Q waves, ST segment depression), coronary calcification, and traditional risk factors (diabetes, obesity, hypertension, hypercholesterolemia, smoking).

Main Results:

  • Significant CAD was identified in 69 patients (60%).
  • Predictive factors for significant CAD included increasing age, family history of premature ischemic heart disease, angina, abnormal Q waves on ECG, ST segment depression on ECG, and coronary calcification.
  • Male gender, diabetes mellitus, and obesity did not correlate with CAD. Hypertension, hypercholesterolemia, and smoking were not useful predictors, potentially due to modification by renal failure.

Conclusions:

  • Increasing age, a family history of premature ischemic heart disease, and specific non-invasive markers are valuable predictors of significant coronary artery disease (CAD) in ESRD patients.
  • These findings can aid in triaging ESRD patients for coronary arteriography before kidney transplantation.
  • Further research may explore the impact of renal failure on traditional cardiovascular risk factors.

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