Cardiovascular Disease Assessment Prior to Kidney Transplantation
Cardiovascular disease is highly prevalent and the leading cause of mortality in patients with chronic kidney disease, end-stage kidney disease, and kidney transplantation. However, kidney transplantation offers improved survival and quality of life, with an overall reduction in cardiovascular disea...
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| Format: | Article |
| Language: | English |
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Houston Methodist DeBakey Heart & Vascular Center
2022-09-01
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| Series: | Methodist DeBakey Cardiovascular Journal |
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| Online Access: | https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1117 |
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| author | Angelina R. Edwards Elise C. Ewing |
| author_facet | Angelina R. Edwards Elise C. Ewing |
| author_sort | Angelina R. Edwards |
| collection | DOAJ |
| description | Cardiovascular disease is highly prevalent and the leading cause of mortality in patients with chronic kidney disease, end-stage kidney disease, and kidney transplantation. However, kidney transplantation offers improved survival and quality of life, with an overall reduction in cardiovascular disease events; therefore, it remains the optimal treatment choice for those with advanced kidney disease. Pretransplantation cardiovascular assessment is performed prior to wait-listing and at routine intervals with the principal goal of screening for asymptomatic cardiac disease, intervening when necessary to improve long-term patient and allograft survival. Current clinical practice guidelines are based on expert opinion, with a lack of high-quality evidence to guide standardized screening practices. Recent studies support de-escalation in screening with avoidance of preemptive revascularization in asymptomatic patients, but they fail to provide clear guidance on how best to assess the cardiovascular fitness of this high-risk group. Herein we summarize current practice guidelines, discuss key study findings, highlight the role of optimal medical therapy, and evaluate future directions for cardiovascular disease assessment in this population. |
| format | Article |
| id | doaj-art-50bb598a4c0743069bb33dae4b2079fd |
| institution | Kabale University |
| issn | 1947-6108 |
| language | English |
| publishDate | 2022-09-01 |
| publisher | Houston Methodist DeBakey Heart & Vascular Center |
| record_format | Article |
| series | Methodist DeBakey Cardiovascular Journal |
| spelling | doaj-art-50bb598a4c0743069bb33dae4b2079fd2025-08-20T03:25:50ZengHouston Methodist DeBakey Heart & Vascular CenterMethodist DeBakey Cardiovascular Journal1947-61082022-09-01184506110.14797/mdcvj.11171135Cardiovascular Disease Assessment Prior to Kidney TransplantationAngelina R. Edwards0https://orcid.org/0000-0003-4609-2388Elise C. Ewing1https://orcid.org/0000-0001-6500-2072Division of Renal Diseases and Hypertension, Houston Methodist Hospital, Houston, Texas; Texas A&M College of Medicine, Houston, TexasDivision of Renal Diseases and Hypertension, Houston Methodist Hospital, Houston, TexasCardiovascular disease is highly prevalent and the leading cause of mortality in patients with chronic kidney disease, end-stage kidney disease, and kidney transplantation. However, kidney transplantation offers improved survival and quality of life, with an overall reduction in cardiovascular disease events; therefore, it remains the optimal treatment choice for those with advanced kidney disease. Pretransplantation cardiovascular assessment is performed prior to wait-listing and at routine intervals with the principal goal of screening for asymptomatic cardiac disease, intervening when necessary to improve long-term patient and allograft survival. Current clinical practice guidelines are based on expert opinion, with a lack of high-quality evidence to guide standardized screening practices. Recent studies support de-escalation in screening with avoidance of preemptive revascularization in asymptomatic patients, but they fail to provide clear guidance on how best to assess the cardiovascular fitness of this high-risk group. Herein we summarize current practice guidelines, discuss key study findings, highlight the role of optimal medical therapy, and evaluate future directions for cardiovascular disease assessment in this population.https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1117cardiovascular screeningkidney transplantationchronic kidney diseaseend stage kidney disease |
| spellingShingle | Angelina R. Edwards Elise C. Ewing Cardiovascular Disease Assessment Prior to Kidney Transplantation Methodist DeBakey Cardiovascular Journal cardiovascular screening kidney transplantation chronic kidney disease end stage kidney disease |
| title | Cardiovascular Disease Assessment Prior to Kidney Transplantation |
| title_full | Cardiovascular Disease Assessment Prior to Kidney Transplantation |
| title_fullStr | Cardiovascular Disease Assessment Prior to Kidney Transplantation |
| title_full_unstemmed | Cardiovascular Disease Assessment Prior to Kidney Transplantation |
| title_short | Cardiovascular Disease Assessment Prior to Kidney Transplantation |
| title_sort | cardiovascular disease assessment prior to kidney transplantation |
| topic | cardiovascular screening kidney transplantation chronic kidney disease end stage kidney disease |
| url | https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1117 |
| work_keys_str_mv | AT angelinaredwards cardiovasculardiseaseassessmentpriortokidneytransplantation AT elisecewing cardiovasculardiseaseassessmentpriortokidneytransplantation |