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Heart Test found safe for Pre-Transplant
Kidney Patients
Newswise — A screening test that measures
whether a patient’s heart is healthy enough
for a kidney transplant is not as dangerous
as once thought, according to a study
appearing in an upcoming issue of the Clinical
Journal of the American Society Nephrology (CJASN).
The findings indicate that the test, called
coronary angiography, does not cause a
decline in kidney function for patients with
advanced chronic kidney disease (CKD) and
can help determine when to schedule a
patient for transplantation.
CKD may contribute to the development of
heart disease, so physicians keep a close
eye on CKD patients’ heart health. However,
they are reluctant to perform coronary
angiography—which uses dye and x-rays to
show the inside of the heart’s arteries—in
CKD patients, who are thought to have an
increased risk of experiencing complications
from the procedure.
This is unfortunate because coronary
angiography can help determine whether a
patient is healthy enough to undergo a
kidney transplant.
To determine the true risks of the test for
patients with advanced CKD, Nicky Kumar,
MBChB, MRCP (West London Renal and
Transplant Centre, Imperial College Kidney
and Transplant Institute, London), and her
colleagues analyzed 76 patients with late
stage CKD who were potential transplant
recipients seen at their clinics from 2004
to 2007. Kidney function measurements were
recorded 12 months before and 12 months
after patients underwent coronary
angiography.
The researchers found that patients’ kidney
function was similar before and after
coronary angiography, indicating that the
procedure was not harmful to the kidneys.
The screening technique detected coronary
artery disease in 23 patients, making them
unsuitable for transplantation until their
heart complications were addressed.
Twenty-two patients’ tests indicated that
they were healthy enough to receive a
transplant instead of going on dialysis.
This kind of information is key to optimal
patient care, since administering a kidney
transplant before the patient needs dialysis
is the most effective treatment for CKD.
The authors report no financial disclosures.
Study co-authors include Lynn Dahri, RGN,
Wendy Brown, RGN, MSc, Neill Duncan, MBBS,
MRCP, Seema Singh MSc, Andrew Palmer, FRCP,
Megan Griffith, FRCP, PhD, Tom Cairns, MBBS,
and David Taube, FRCP (West London Renal and
Transplant Centre, Imperial College Kidney
and Transplant Institute, London);
Christopher Baker, FRCP, PhD, and Iqbal
Malik, MBBChir, MA, MRCP (Imperial College
Healthcare NHS Trust, London).
Founded in 1966, the American Society of
Nephrology (ASN) is the world’s largest
professional society devoted to the study of
kidney disease. Comprised of 11,000
physicians and scientists, ASN continues to
promote expert patient care, to advance
medical research, and to educate the renal
community.
ASN also informs policymakers about issues
of importance to kidney doctors and their
patients. ASN funds research, and through
its world-renowned meetings and first-class
publications, disseminates information and
educational tools that empower physicians.
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