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Abstract: SA-PO834

Findings From a Cardiovascular Screening Workup of Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Arabi, Ziad, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Youssouf, Talha Mohammad, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Abdulgadir, Mohamad Yousif, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Alawadh, Nayef, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Iqbal, Dr Junaid, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Abdalla, Mubarak Ibrahim, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Alflaiw, Ahmad I., Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Background

There is limited data about the findings of cardiovascular (CV) workup of kidney transplant recipients (KTR). Our center follows the AHA/ ACC 2013 guidlines of the cardiovascular risk assessment of renal transplant candidates (KTC). Screening echo is performed in all KTC. PET stress nuclear test is done in those who have ≥3 CV risk factors, limited functional status or abnormal echo findings. Decision of cardiac catheterization is deferred to cardiologist’s assessment. Abdominal/ pelvis CT with IV contrast is done to evaluate the extent of pelvic vascular calcifications and atherosclerosis. It is performed in most the KTC unless if they are on PD, undergoing preemptive transplantation or at low surgical risk.

Methods

In this single center retrospective study, we reviewed the prevalence of CV risk factors and the results of the CVworkup of KTR who underwent renal transplant from 2017 to 2020.

Results

A total of 287 KTR were included. 74% were ≥ 30 years, 58% were men and 80% were living-donor KTR.

Preemptive transplantation was 10.1%. Pre- KT dialysis modality was PD in 11.5% and HD in 78.4% (AVF: 42% versus Permcath: 58%). Dialysis vintage was 4.8±3.3 years for DDKT versus 2.4±2.6 years for LKT.

CV risk factors among KTR were:
CAD: 13.2%, CVD: 5.2%, PVD: 2.8%, CVA: 2.4%, HTN: 76%, DM: 34.5%, [DM type I: 25 (25.3%) and DM type II: 74 (74.7%%)], HLP (LDL> 100):39.7% and smoking:10.1%. The prevalence of obesity stage 2 (BMI 35-39.9): 4%, and obesity stage 1 (BMI: 30-34.9) was 20%.

LVH was present in 38%. EF was abnormal (<55) in 20.5% [45-55: 43 (15%), 35-45: 15 (5.2%), 25-35:1 (0.3%)]. Abnormal wall motion (mostly global dyskinesia) was present in 12%.

Stress test was indicated in 152 (53.3%) and it showed abnormal perfusion in 26% of cases. Calcium scoring: >400: in 17%, zero in 43%, 1-100: in 42 (27%), and 100-400: in 13%.

Cardiac catheterization was required in only 46 (16%) and findings were: CAD for intervention in 26%, CAD for med TX in 63% and no CAD in 11%

CT abdomen and pelvis was performed in (138) 38.1% and findings were: moderate or severe calcifications/ atherosclerosis in only 6%, normal in 82% or only mild calcifications in 12%.

Conclusion

This study outlines the high prevalence of CV risk factors in KTR and the findings of pre-KT CV workup.