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J R Soc Med. 1997 March; 90(3): 136–137.
PMCID: PMC1296177

Non-invasive cardiac investigations in patients awaiting renal transplantation.


Patients with chronic renal failure undergoing renal transplantation have a high prevalence of cardiovascular disease. Invasive investigation may identify those at risk of cardiac death during or after renal transplantation, but which patients should undergo cardiac catheterization is currently not clear. In 95 patients awaiting renal transplantation we assessed the ability of echocardiography and exercise electrocardiography to identify patients at risk of cardiac death. Echocardiography identified impaired left ventricular (LV) systolic function in 20%, severe in 8%. Of the patients with severe LV dysfunction, 25% died before transplantation. Of those undergoing exercise electrocardiography, 44% did not achieve 85% of maximum predicted heart rate. No coronary artery disease requiring intervention was identified by exercise testing. These findings indicate that echocardiography, but not exercise electrocardiography, should be part of the assessment for renal transplantation.

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Selected References

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  • Weinrauch LA, D'Elia JA, Monaco AP, Gleason RE, Welty F, Nishan PC, Nesto RW. Preoperative evaluation for diabetic renal transplantation: impact of clinical, laboratory, and echocardiographic parameters on patient and allograft survival. Am J Med. 1992 Jul;93(1):19–28. [PubMed]
  • Manske CL, Wang Y, Rector T, Wilson RF, White CW. Coronary revascularisation in insulin-dependent diabetic patients with chronic renal failure. Lancet. 1992 Oct 24;340(8826):998–1002. [PubMed]
  • Derfler K, Kletter K, Balcke P, Heinz G, Dudczak R. Predictive value of thallium-201-dipyridamole myocardial stress scintigraphy in chronic hemodialysis patients and transplant recipients. Clin Nephrol. 1991 Oct;36(4):192–202. [PubMed]

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