P1784CARDIOVASCULAR RISK ASSESSMENT PRIOR TO KIDNEY TRANSPLANTATION

Abstract

Abstract Background and Aims Cardiovascular diseases (CVD) are the most frequent cause of death in dialysed patients. Patients in the risk group of CVD examined prior to kidney transplantation (KTx) are indicated for coronarography (SCG). The aim of our analysis was to identify risk factors (RF) for positive finding of patients undergoing SCG before KTx. Method Our analysis consisted of 55 dialysed patients (46 males, 9 females, P<0.0001), undergoing SCG before inclusion on waiting list (WL). We identified patient’s information (age in the time of SCG, gender, ethiology of kidney failure, comorbidities - arterial hypertension, ischemic heart disease /IHD/, diabetes mellitus /DM/), biochemical parameters in the time of SCG (serum level of lipids, haemoglobin, calcium-phosphate metabolism). We divided patients, according to SCG results (negative finding; n=40 v.s positive finding; n=15). Results Patients without percutaneous coronary intervention (PCI) (negative finding) we confirmed significantly lower incidence of diabetic nephropathy (P=0.0484) IHD (P=0.0174) and coronary artery disease (P=0.0001). We confirmed, haemodynamically significant coronary stenosis correlate with the occurrence of stroke or transient ischemic attack in patient’s history (P=0.0104). Consequently, we identified predictors for realization PCI (positive result): type 2 DM [OR 2,3492 (P=0.0472)], HDL ≤ 1,03 mmol/l [OR 4.3276 (P=0.0359)], total calcium level ≤ 2mmol/l [OR 2.4935 (P=0.0309)], phosphate level ≥ 1.45 mmol/l [OR 0.2034 (P=0.0351)]. In our analysis, patients non-listed on WL had significantly higher incidence of type 2 DM (P=0.0087), smoking (P=0.0079) and were treated more often with statins (P=0.0025). Conclusion In our analysis, patients with DM and poorly managed chronic kidney disease - mineral bone disease are the most at risk group in the group of patients with CVD with positive SCG finding. Patients with high cardiovascular risk, without DM or other RF can profit from non-invasive imaging methods following faster listing on WL.