Cardiovascular Screening and Management among Kidney Transplant Candidates in Hungary

R. P. Szabó, I. Varga, J. Balla, L. Zsom, B. Nemes

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction Cardiovascular disease is a major cause of morbidity and mortality in end-stage renal disease patients on dialysis and the most common cause of death in the immediate post-transplantation period. The aim of our study was to describe a novel approach of cardiovascular screening and management of dialysis patients evaluated for the transplant waiting list. Methods Twenty-eight patients with end-stage renal disease put on the waiting list between July 2013 and July 2014 were subjected to a prespecified cardiovascular screening protocol utilizing noninvasive and/or invasive tests. Patients were subsequently divided into 3 strata in terms of their estimated cardiovascular risk. Each of these groups were then prescribed interventions aiming to improve their cardiovascular condition. Results According to our prespecified protocol of cardiovascular screening studies, 15 (54%) patients were identified as low, 5 (18%) as intermediate, and 8 (28%) as high risk. Four (14%) patients were current smokers. In the low-risk group, we initiated a patient education program involving counseling on regular exercise such as swimming or cycling to improve their functional capacity. In the high-risk group revascularization was done in 5 cases (63%), including 3 percutaneous transluminal coronary angioplasties (PTCA) with stents for single-vessel disease, and coronary artery bypass graft surgeries (CABG) for triple-vessel disease in 2 cases. In the medium-risk group medical management was opted for, including introduction of beta-blockers, inhibitors, statins, and ezetimibe, as well as efforts to optimize anemia management, indices of bone-mineral disease, and fluid status. Conclusion In our regional transplant program, we introduced a comprehensive multidisciplinary approach to treat potential transplant candidates according to cardiovascular risk stratification based on a prespecified screening protocol. Further studies are needed to correlate this novel strategy with post-transplantation outcomes.

Original languageEnglish
Pages (from-to)2192-2195
Number of pages4
JournalTransplantation Proceedings
Volume47
Issue number7
DOIs
Publication statusPublished - Sep 1 2015

Fingerprint

Hungary
Transplants
Kidney
Waiting Lists
Chronic Kidney Failure
Dialysis
Transplantation
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Coronary Balloon Angioplasty
Bone Diseases
Patient Education
Coronary Artery Bypass
Stents
Minerals
Counseling
Anemia
Cause of Death
Cardiovascular Diseases
Exercise
Morbidity

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Cardiovascular Screening and Management among Kidney Transplant Candidates in Hungary. / Szabó, R. P.; Varga, I.; Balla, J.; Zsom, L.; Nemes, B.

In: Transplantation Proceedings, Vol. 47, No. 7, 01.09.2015, p. 2192-2195.

Research output: Contribution to journalArticle

@article{24ca5fcee735477192beef4c1e716f6c,
title = "Cardiovascular Screening and Management among Kidney Transplant Candidates in Hungary",
abstract = "Introduction Cardiovascular disease is a major cause of morbidity and mortality in end-stage renal disease patients on dialysis and the most common cause of death in the immediate post-transplantation period. The aim of our study was to describe a novel approach of cardiovascular screening and management of dialysis patients evaluated for the transplant waiting list. Methods Twenty-eight patients with end-stage renal disease put on the waiting list between July 2013 and July 2014 were subjected to a prespecified cardiovascular screening protocol utilizing noninvasive and/or invasive tests. Patients were subsequently divided into 3 strata in terms of their estimated cardiovascular risk. Each of these groups were then prescribed interventions aiming to improve their cardiovascular condition. Results According to our prespecified protocol of cardiovascular screening studies, 15 (54{\%}) patients were identified as low, 5 (18{\%}) as intermediate, and 8 (28{\%}) as high risk. Four (14{\%}) patients were current smokers. In the low-risk group, we initiated a patient education program involving counseling on regular exercise such as swimming or cycling to improve their functional capacity. In the high-risk group revascularization was done in 5 cases (63{\%}), including 3 percutaneous transluminal coronary angioplasties (PTCA) with stents for single-vessel disease, and coronary artery bypass graft surgeries (CABG) for triple-vessel disease in 2 cases. In the medium-risk group medical management was opted for, including introduction of beta-blockers, inhibitors, statins, and ezetimibe, as well as efforts to optimize anemia management, indices of bone-mineral disease, and fluid status. Conclusion In our regional transplant program, we introduced a comprehensive multidisciplinary approach to treat potential transplant candidates according to cardiovascular risk stratification based on a prespecified screening protocol. Further studies are needed to correlate this novel strategy with post-transplantation outcomes.",
author = "Szab{\'o}, {R. P.} and I. Varga and J. Balla and L. Zsom and B. Nemes",
year = "2015",
month = "9",
day = "1",
doi = "10.1016/j.transproceed.2015.07.018",
language = "English",
volume = "47",
pages = "2192--2195",
journal = "Transplantation Proceedings",
issn = "0041-1345",
publisher = "Elsevier USA",
number = "7",

}

TY - JOUR

T1 - Cardiovascular Screening and Management among Kidney Transplant Candidates in Hungary

AU - Szabó, R. P.

AU - Varga, I.

AU - Balla, J.

AU - Zsom, L.

AU - Nemes, B.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Introduction Cardiovascular disease is a major cause of morbidity and mortality in end-stage renal disease patients on dialysis and the most common cause of death in the immediate post-transplantation period. The aim of our study was to describe a novel approach of cardiovascular screening and management of dialysis patients evaluated for the transplant waiting list. Methods Twenty-eight patients with end-stage renal disease put on the waiting list between July 2013 and July 2014 were subjected to a prespecified cardiovascular screening protocol utilizing noninvasive and/or invasive tests. Patients were subsequently divided into 3 strata in terms of their estimated cardiovascular risk. Each of these groups were then prescribed interventions aiming to improve their cardiovascular condition. Results According to our prespecified protocol of cardiovascular screening studies, 15 (54%) patients were identified as low, 5 (18%) as intermediate, and 8 (28%) as high risk. Four (14%) patients were current smokers. In the low-risk group, we initiated a patient education program involving counseling on regular exercise such as swimming or cycling to improve their functional capacity. In the high-risk group revascularization was done in 5 cases (63%), including 3 percutaneous transluminal coronary angioplasties (PTCA) with stents for single-vessel disease, and coronary artery bypass graft surgeries (CABG) for triple-vessel disease in 2 cases. In the medium-risk group medical management was opted for, including introduction of beta-blockers, inhibitors, statins, and ezetimibe, as well as efforts to optimize anemia management, indices of bone-mineral disease, and fluid status. Conclusion In our regional transplant program, we introduced a comprehensive multidisciplinary approach to treat potential transplant candidates according to cardiovascular risk stratification based on a prespecified screening protocol. Further studies are needed to correlate this novel strategy with post-transplantation outcomes.

AB - Introduction Cardiovascular disease is a major cause of morbidity and mortality in end-stage renal disease patients on dialysis and the most common cause of death in the immediate post-transplantation period. The aim of our study was to describe a novel approach of cardiovascular screening and management of dialysis patients evaluated for the transplant waiting list. Methods Twenty-eight patients with end-stage renal disease put on the waiting list between July 2013 and July 2014 were subjected to a prespecified cardiovascular screening protocol utilizing noninvasive and/or invasive tests. Patients were subsequently divided into 3 strata in terms of their estimated cardiovascular risk. Each of these groups were then prescribed interventions aiming to improve their cardiovascular condition. Results According to our prespecified protocol of cardiovascular screening studies, 15 (54%) patients were identified as low, 5 (18%) as intermediate, and 8 (28%) as high risk. Four (14%) patients were current smokers. In the low-risk group, we initiated a patient education program involving counseling on regular exercise such as swimming or cycling to improve their functional capacity. In the high-risk group revascularization was done in 5 cases (63%), including 3 percutaneous transluminal coronary angioplasties (PTCA) with stents for single-vessel disease, and coronary artery bypass graft surgeries (CABG) for triple-vessel disease in 2 cases. In the medium-risk group medical management was opted for, including introduction of beta-blockers, inhibitors, statins, and ezetimibe, as well as efforts to optimize anemia management, indices of bone-mineral disease, and fluid status. Conclusion In our regional transplant program, we introduced a comprehensive multidisciplinary approach to treat potential transplant candidates according to cardiovascular risk stratification based on a prespecified screening protocol. Further studies are needed to correlate this novel strategy with post-transplantation outcomes.

UR - http://www.scopus.com/inward/record.url?scp=84941013392&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84941013392&partnerID=8YFLogxK

U2 - 10.1016/j.transproceed.2015.07.018

DO - 10.1016/j.transproceed.2015.07.018

M3 - Article

VL - 47

SP - 2192

EP - 2195

JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

IS - 7

ER -