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. de Mattos, Raed A. Aqel

Research output: Contribution to journalArticlepeer-review

79 Scopus citations

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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