Heart test found safe for pre-transplant kidney patients

LONDON - A test that screens whether a patient’s heart is healthy enough for a kidney transplant is not as dangerous as once thought, a new study reveals.

It indicates that the test, called coronary angiography, does not cause a decline in kidney function for patients with advanced chronic kidney disease (CKD) and can help determine when to schedule a patient for a transplant.

CKD may contribute to the development of heart disease, so physicians keep a close eye on CKD patients’ heart health.

However, they are reluctant to perform coronary angiography — which uses dye and x-rays to show the inside of the heart’s arteries — in CKD patients, who are thought to have an increased risk of experiencing complications from the procedure.

This is unfortunate because coronary angiography can help determine whether a patient is healthy enough to undergo a kidney transplant.

To determine such risks, Nicky Kumar, Imperial College Kidney and Transplant Institute, London and colleagues analysed 76 patients with late stage CKD who were potential transplant recipients seen at their clinics from 2004 to 2007.

Kidney function measurements were recorded 12 months before and 12 months after patients underwent coronary angiography.

The researchers found that patients’ kidney function was similar before and after coronary angiography, indicating that the procedure was not harmful to the kidneys.

The screening technique detected coronary artery disease in 23 patients, making them unsuitable for transplant until their heart complications were addressed, said an Imperial College release.

Twenty-two patients’ tests indicated that they were healthy enough to receive a transplant instead of going on dialysis.

This kind of information is key to optimal patient care, since administering a kidney transplant before the patient needs dialysis is the most effective treatment for CKD.

The study will appear in the Clinical Journal of the American Society Nephrology (CJASN).