Related Experiment Video
Updated: Jun 4, 2025
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Cardiac evaluation of renal transplant candidates with heart failure
Amer Ashaab Belal1, Alfonso Hernandez Santos2, Amir Kazory2
1Department of Medicine, Division of Nephrology, University of Florida College of Medicine, Gainesville, FL 32610, United States. abelal@ufl.edu.
Insights
Patients with advanced kidney disease face higher heart failure risks. This review explores risk stratification for non-ischemic heart failure to improve kidney transplant eligibility and patient outcomes.
Area of Science:
- Nephrology
- Cardiology
- Transplantation
Background:
- Patients with advanced kidney disease (CKD) have a high risk of heart failure.
- Accurate risk stratification is crucial for determining kidney transplant eligibility.
- Existing guidelines focus on coronary heart disease, necessitating evaluation for other heart failure types.
Purpose of the Study:
- To review literature on risk stratification for non-ischemic heart failure in advanced CKD patients.
- To discuss strategies for optimizing patients before kidney transplantation.
- To aid clinicians in evaluating potential kidney transplant recipients.
Main Methods:
- Literature review of studies on non-ischemic heart failure and functional cardiac conditions.
- Analysis of risk stratification strategies for advanced CKD patients.
Main Results:
- Non-ischemic heart failure and pulmonary hypertension are significant concerns in advanced CKD.
- Optimizing volume status via ultrafiltration is a key pre-transplant strategy.
- Kidney transplantation improves survival compared to long-term dialysis.
Conclusions:
- Refined risk stratification for non-ischemic heart failure is needed for advanced CKD patients.
- Optimizing cardiac and volume status is vital before transplantation.
- Kidney transplantation offers survival benefits for patients with advanced CKD and cardiac disease.
Abstract:
Patients with advanced kidney disease are at elevated risk of developing heart failure and appropriate risk stratification is important to permit them to receive kidney transplantation. The American Heart Association and American College of Cardiology joint statement provides guidance on risk stratification for the major cause of heart failure for these patients in its recommendations for coronary heart disease. Herein we provide an overview of the available literature on risk stratification for nonischemic heart failure and functional heart disease states such as pulmonary hypertension. Many of these options for optimizing these patients before transplant include optimizing their volume status, often with more aggressive ultrafiltration. Kidney transplantation remains the treatment of choice for patients with advanced kidney disease and cardiac disease, the correction of the azotemic substances with kidney transplantation has been associated with improved survival than remaining on dialysis long-term. The findings in the studies reviewed here are expected to help clinicians refine current strategies for evaluating potential kidney transplant recipients.
Related Concept Videos
01:22Heart Failure Drugs: Diuretics
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:28Imaging Studies for Cardiovascular System V: CT
01:28Mitral Regurgitation IV: Nursing Management
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...