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*

*Corresponding author for this work

Research output: Contribution to journalArticle

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

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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