Abstract 16810: Myocardial Perfusion Abnormalities, Ejection Fraction, and Coronary Calcium Score Are Not Associated With All-Cause Mortality Among Potential Kidney Transplant Recipients at Emory University Hospital

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ryan S Cousins ◽  
Billy Mullinax ◽  
Lehman Godwin ◽  
Adam J Mitchell
Keyword(s):  
Multivariate Analysis ◽  
Coronary Artery ◽  
Kidney Transplant ◽  
Stress Testing ◽  
University Hospital ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Evaluation ◽  
Emory University ◽  
All Cause Mortality

Introduction: Screening for coronary artery disease in patients being considered for kidney transplant is common to stratify morbidity and mortality risk, but the optimal strategy, and its impact on outcomes, remains unclear. Here we test the hypothesis that myocardial perfusion imaging (MPI) abnormalities, left ventricular ejection fraction (LVEF), or coronary artery calcium (CAC) score are associated with all-cause mortality in potential kidney transplant recipients at Emory University Hospital (EUH). Methods: In a retrospective chart review, we assessed the relationship between patient demographics, single-photon emission MPI results, and CAC scoring with post-evaluation outcomes at 5 years in consecutive patients referred for pre-transplant stress testing at EUH in 2015. Mann-Whitney U and Chi-Square tests assessed between-group differences in continuous and categorical variables, respectively. Multivariate analysis was performed using logistic regression models. Results: During the study period, 589 patients (mean age 54 years; SEM 0.512, 58% male, 65% African American) underwent MPI and 424 also underwent CAC scoring. Overall, 90 patients (15%) had abnormal MPI (defined as any fixed or reversible defect) and 54 (9%) died during follow up. Age (mean 53.2 years; SEM 0.533 vs. 57.7 years; SEM 1.73, p=0.008), previous coronary artery bypass graft (CABG) (2.06% vs. 7.41%, p=0.017), and myocardial infarction (MI) post-evaluation (4.11% vs. 18.5%, p<0.001) were associated with all-cause mortality. Age (p=0.032) and MI post-evaluation (p<0.001) remained significant in multivariate analysis. MPI abnormalities, LVEF, and CAC score were not associated with all-cause mortality. Conclusions: Age and MI post-evaluation are associated with increased mortality in potential kidney transplant recipients referred for stress testing at EUH. We found no association between MPI abnormalities, LVEF, or CAC score and all-cause mortality.

scholarly journals Early Subclinical Coronary Artery Calcification in Young Adults Who Were Pediatric Kidney Transplant Recipients

2005 ◽  
Vol 5 (7) ◽  
pp. 1689-1693 ◽  
Author(s):  
Michael B. Ishitani ◽  
Dawn S. Milliner ◽  
Dean Y. Kim ◽  
Humberto E. Bohorquez ◽  
Julie K. Heimbach ◽  
...  
Keyword(s):  
Young Adults ◽  
Coronary Artery ◽  
Kidney Transplant ◽  
Coronary Artery Calcification ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals P1708EFFECT OF PREGNANCY ON KIDNEY TRANSPLANT RECIPIENTS: A PROPENSITY SCORE-MATCHED STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Toyofumi Abe ◽  
Taniguchi Ayumu ◽  
Kawamura Masataka ◽  
Kato Taigo ◽  
Tomoko Namba-Hamano ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
P Value ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Pregnancy And Delivery

Abstract Background and Aims This study aimed to evaluate whether the experience of pregnancy and delivery would be associated with poor maternal outcome among kidney transplant recipients. Method A total of 401 female transplant recipients from the Osaka University Transplantation Group Database were included in this study. 73 women who underwent renal transplantation between 1970 and 2017 and became pregnant and delivered at Osaka University Kidney Transplant Group Hospitals. Multivariable logistic regression analysis was used to assess the impact of pregnancy and delivery on renal transplant recipient outcome after one-to-one propensity score (PS) matching for 12 variables including serum creatinine at one year post-transplant between the parous group and the nulliparous group. The outcomes were kidney graft survival and patient survival. Results In all patients before PS matching, 75 (18.7%) of the 401 patients died and 137 (34.2%) of the 401 patients lost their kidney grafts during the follow-up period. In the multivariate analysis, pregnancy and delivery was not a significant risk factor for death (adjusted HR 0.662 [95%CI, 0.265-1.656], p-value 0.378) and for death-censored graft survival (adjusted HR 1.224 [95%CI, 0.683-2.196], p-value 0.497). In the PS matched population, 14 (17.5%) of the 80 patients died and 31 (38.8%) of the 80 patients lost their grafts. In the multivariate analysis, pregnancy and delivery was not a significant risk factor for death (adjusted HR 0.611 [95%CI, 0.180-2.072], p-value 0.430) and for death-censored graft survival (adjusted HR 1.308 [95%CI, 0.501-3.416], p-value 0.584). Conclusion Pregnancy and delivery after kidney transplantation was not associated with poor kidney transplant outcome in recipients with adequate and stable graft function.

scholarly journals Osmoregulation Performance and Kidney Transplant Outcome

2019 ◽  
Vol 30 (7) ◽  
pp. 1282-1293 ◽  
Author(s):  
Manal Mazloum ◽  
Jordan Jouffroy ◽  
François Brazier ◽  
Christophe Legendre ◽  
Antoine Neuraz ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Renal Outcome ◽  
Plasma Sodium ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Loading Test ◽  
Water Loading ◽  
All Cause Mortality ◽  
Allograft Loss ◽  
Transplantation Outcomes

BackgroundKidney transplant recipients have an impaired ability to dilute urine but seldom develop baseline hyponatremia before ESRD. Although hyponatremia is a risk factor for adverse events in CKD and in kidney transplant recipients, it remains unclear whether subtler alterations in osmoregulation performance are associated with outcome.MethodsWe studied a single-center prospective cohort of 1258 kidney transplant recipients who underwent a water-loading test 3 months after transplant to determine osmoregulation performance. Measured GFR (mGFR) was performed at the same visit. A group of 164 healthy candidates for kidney donation served as controls. We further evaluated the association of osmoregulation performance with transplantation outcomes and subsequent kidney function.ResultsUnlike controls, most kidney transplant recipients failed to maintain plasma sodium during water loading (plasma sodium slope of −0.6±0.4 mmol/L per hour in transplant recipients versus −0.12±0.3 mmol/L per hour in controls; P<0.001). Steeper plasma sodium reduction during the test independently associated with the composite outcome of all-cause mortality and allograft loss (hazard ratio [HR], 1.73 per 1 mmol/L per hour decrease in plasma sodium; 95% confidence interval [95% CI], 1.23 to 2.45; P=0.002) and allograft loss alone (HR, 2.04 per 1 mmol/L per hour decrease in plasma sodium; 95% CI, 1.19 to 3.51; P=0.01). The association remained significant in a prespecified sensitivity analysis excluding patients with hyperglycemia. In addition, a steeper plasma sodium slope 3 months after transplantation independently correlated with lower mGFR at 12 months (β=1.93; 95% CI, 0.46 to 3.41; P=0.01).ConclusionsReduced osmoregulation performance occurs frequently in kidney transplant recipients and is an independent predictor of renal outcome.

scholarly journals Pretransplant Physical Activity Predicts All-Cause Mortality in Kidney Transplant Recipients

2011 ◽  
Vol 35 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Sylvia E. Rosas ◽  
Peter P. Reese ◽  
Yonghong Huan ◽  
Cataldo Doria ◽  
Philip T. Cochetti ◽  
...  
Keyword(s):  
Physical Activity ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
All Cause Mortality
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