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Published on: April 12, 2021

Predictors of survival in patients with end-stage renal disease evaluated for kidney transplantation

Fadi G Hage1, Stuart Smalheiser, Gilbert J Zoghbi

  • 1Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA.

The American Journal of Cardiology
|September 11, 2007
PubMed

Insights

For patients with end-stage renal disease awaiting kidney transplants, left ventricular ejection fraction is a key predictor of survival. Improving cardiac function may enhance outcomes for this high-risk population.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplantation Medicine

Background:

  • Cardiovascular disease is the leading cause of death in patients with end-stage renal disease (ESRD).
  • Understanding mortality predictors in ESRD patients awaiting kidney transplantation is crucial for improving patient outcomes.

Purpose of the Study:

  • To identify predictors of all-cause mortality in patients with ESRD evaluated for kidney transplantation.
  • To assess the prognostic value of coronary angiography and myocardial perfusion imaging in this cohort.

Main Methods:

  • Retrospective analysis of 3,698 ESRD patients evaluated for kidney transplantation between 2001 and 2004.
  • Utilized stress myocardial perfusion imaging (MPI) and coronary angiography to assess cardiac status.
  • Correlated imaging findings and interventions with all-cause mortality during a mean follow-up of 30 months.

Main Results:

  • Left ventricular ejection fraction (LVEF) measured by MPI was the strongest predictor of death.
  • A 1% decrease in LVEF was associated with a 2.7% increase in mortality risk.
  • Coronary angiography findings and revascularization did not predict survival, except in patients with 3-vessel disease.

Conclusions:

  • LVEF is a critical determinant of survival in ESRD patients awaiting renal transplantation.
  • Strategies aimed at improving cardiac function or facilitating earlier transplantation warrant investigation.
  • Further research is needed to optimize cardiovascular care in ESRD patients.

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