The prevalence and types of cardiovascular disease in patients with end-stage renal disease undergoing renal transplantation.

BACKGROUND: Cardiovascular disease (CVD) is the most common cause of death in patients with end-stage renal disease (ESRD) as well as in renal transplant recipients (RTR). In this study we sought to evaluate the prevalence and the types of CVD in patients with ESRD undergoing renal transplantation. PATIENTS AND METHODS: The data of 500 consecutive patients with ESRD undergoing renal transplantation were evaluated retrospectively. Demographic findings, clinical variables, and laboratory results including invasive and noninvasive cardiologic tests were recorded.
RESULTS: The mean age of patients was 31.6 ± 10.2 years, of whom 133 (26.6%) were female. The prevalence of major atherosclerotic risk was as follows: hypertension 62.2%, diabetes mellitus 3.4%, smoking 26.4%, dyslipidemia 13.2%, and family history of atherosclerosis 9.8%. Treadmill exercise test was performed on 139 subjects, and myocardial perfusion scintigraphy on 73. Coronary artery disease was identified in 16 of 42 cases (38.1%) who had undergone angiography. Eight patients underwent percutaneous coronary intervention, and coronary bypass surgery was performed on 4 cases prior to renal transplantation. On echocardiographic examination mean ejection fraction was 51.9 ± 7.1%, and wall motion abnormality was detected in 15% of cases. The most prevalent valvular disease was mitral regurgitation (45.8%) followed by tricuspid regurgitation (30.6%).
CONCLUSION: The findings of this study indicate that CVD and atherosclerotic risk factors are common in patients with ESRD undergoing renal transplantion. With regard to the prognostic significance, pretransplantation identification of these conditions is of paramount importance. As a result, improved detection of occult CV disorders results in the possiblity of improved outcomes following renal transplantation.