Predictors of Survival in Patients With End-Stage Renal Disease Evaluated for Kidney Transplantation

Fadi G. Hage, Stuart Smalheiser, Gilbert J. Zoghbi, Gilbert J. Perry, Mark Deierhoi, David Warnock, Ami E. Iskandrian, Angelo M DeMattos, Raed A. Aqel

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Abstract

Cardiovascular disease is the major cause of mortality in patients with end-stage renal disease (ESRD). This study examined the all-cause mortality in 3,698 patients with ESRD evaluated for kidney transplantation at our institution from 2001 to 2004. Mean age for the cohort was 48 ± 12 years, and 42% were women. Stress myocardial perfusion imaging was done in 2,207 patients (60%) and coronary angiography in 260 patients (7%). There were 622 deaths (17%) during a mean follow-up period of 30 ± 15 months. The presence and severity of coronary disease on angiography was not predictive of survival. Coronary revascularization did not impact survival (p = 0.6) except in patients with 3-vessel disease (p = 0.05). The best predictor of death was left ventricular ejection fraction, measured by gated myocardial perfusion imaging, with 2.7% mortality increase for each 1% ejection fraction decrease. In conclusion, left ventricular ejection fraction is a strong predictor of survival in patients with ESRD awaiting renal transplantation. Strategies to improve cardiac function or earlier renal transplantation deserve further studies.

Original languageEnglish (US)
Pages (from-to)1020-1025
Number of pages6
JournalAmerican Journal of Cardiology
Volume100
Issue number6
DOIs
StatePublished - Sep 15 2007
Externally publishedYes

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hage, F. G., Smalheiser, S., Zoghbi, G. J., Perry, G. J., Deierhoi, M., Warnock, D., Iskandrian, A. E., DeMattos, A. M., & Aqel, R. A. (2007). Predictors of Survival in Patients With End-Stage Renal Disease Evaluated for Kidney Transplantation. American Journal of Cardiology, 100(6), 1020-1025. https://doi.org/10.1016/j.amjcard.2007.04.045