Preoperative noncoronary cardiovascular assessment and management of kidney transplant candidates

Jayson Rakesh Baman, Joseph Knapper, Zankhana Raval, Matthew E. Harinstein, John J. Friedewald, Kameswari Maganti, Michael J. Cuttica, Michael I. Abecassis, Ziad A. Ali, Mihai Gheorghiade, James D. Flaherty

Research output: Contribution to journalArticlepeer-review

Abstract

The pretransplant risk assessment for patients with ESKD who are undergoing evaluation for kidney transplant is complex and multifaceted. When considering cardiovascular disease in particular, many factors should be considered. Given the increasing incidence of kidney transplantation and the growing body of evidence addressing ESKD-specific cardiovascular risk profiles, there is an important need for a consolidated, evidence-based model that considers the unique cardiovascular challenges that these patients face. Cardiovascular physiology is altered in these patients by abrupt shifts in volume status, altered calcium-phosphate metabolism, high-output states (in the setting of arteriovenous fistulization), and adverse geometric and electrical remodeling, to name a few. Here, we present a contemporary review by addressing cardiomyopathy/heart failure, pulmonary hypertension, valvular dysfunction, and arrhythmia/sudden cardiac death within the ESKD population.

Original languageEnglish (US)
Pages (from-to)1670-1676
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume14
Issue number11
DOIs
StatePublished - Nov 7 2019

Bibliographical note

Funding Information:
Dr. Ali reports grants from Abbott Vascular and Cardiovascular Systems Inc.; personal fees from Acist Medical, AstraZeneca, Boston Scientific, Cardinal Health, and Opsens Medical; and personal and other fees such as stock from Shockwave Medical, outside the submitted work. Dr. Cuttica reports grants for clinical trials, personal fees from speaker bureaus and advisory board consulting, and nonfinancial support from Actelion and United Therapeutics; grants for clinical trials, personal fees from speaker bureaus and advisory board consulting, and nonfinancial support from Bayer and Gilead; and a clinical trial grant from Reata Pharmaceuticals, outside of the submitted work. Dr. Friedewald reports grants and personal fees from AbbVie; personal fees from American Society of Nephrology; personal fees from Novartis; personal fees from Sanofi; grants from Shire; grants, personal fees, and other fees including equity interest from Transplant Genomics, Inc.; grants from Vaiteris; and personal fees from Viela Bio, outside the submitted work. Dr. Abecassis, Dr. Baman, Dr. Flaherty, Dr. Harinstein, Dr. Knapper, Dr. Maganti, and Dr. Raval have nothing to disclose.

Publisher Copyright:
© 2019, American Society of Nephrology. All rights reserved.

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