La ausencia de manifestaciones clínicas que sugieran isquemia coronaria pretrasplante renal es suficiente para predecir la ausencia de eventos coronarios postrasplante

Abstract

The association between kidney disease and coronary disease is well established, so special care must be taken in the cardiological assessment carried out before being added to the renal transplant waiting list. The performing of a routine coronary arteriography has also been proposed. Objective To analyse whether the clinical assessment is sufficient to predict the absence of post-transplant coronary events. Patients and method A total of 256 current dialysis patients were examined in Cardiology. An electrocardiogram, echo doppler and a clinical assessment were performed on all the patients. Other examinations were not performed if the clinical signs were not suggestive of ischaemia. Post-transplant coronary events were analysed on those who had received a renal graft. Results There were 94 (36.7%) patients on the kidney transplant waiting list. Age: 50.12 ± 13.8 years; 57 (60.6%) men; 13 (13.8%) diabetics. Only one patient (1.06%) showed coronary disease at the time of being added to the waiting list. The coronary arteriography on the first assessment or during the monitoring was performed on 3 patients (3.2%) and two of them showed coronary disease. As result of an acute coronary syndrome, a patient died while on the waiting list. Fifty-two (55%) patients were transplanted after 29.3 ± 13.3 months on the waiting list (median: 35). After the transplant, they were followed up for 22.1 (16.5) months (median: 20), without any cardiological events. Conclusions 1. The pre-inclusion of cardiological clinical assessment on the renal transplant list was sufficient to predict the absence of post-transplant coronary complications. 2. Additional procedures were not necessary when there are no clinical signs that suggest the presence of coronary ischaemia.