Practice patterns of dialysis access and outcomes in patients wait-listed early for kidney transplantation

Sylvestre, Raphaëlle; Pinho, Natália Alencar de; Massy, Ziad A.; Jacquelinet, Christian; Prézelin-Reydit, Mathilde; Galland, Roula; Stengel, Bénédicte; Coscas, Raphaël

doi:10.1186/s12882-020-02080-5

Cited by 4 publications

(4 citation statements)

References 40 publications

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“…Hemodialysis catheters may be considered as a viable bridge therapy option in patients with living donor availability [ 34 ]. However, pre-KTx dialysis duration may be quite long even when planned with a living donor [ 35 ]. The advantages of protecting these patients from AVF creation must be carefully evaluated against catheter-related risks [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Findings of Cardiovascular Workup of Kidney Transplant Candidates: A Retrospective Study of a Single-Center in Saudi Arabia

Arabi,

Tawhari,

Al Rajih

et al. 2023

International Journal of Nephrology

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Background. There are limited data about the prevalence of cardiovascular (CV) risk factors and the findings of CV workup among kidney transplant (KTx) recipients (KTRs) in Saudi Arabia. Methods. A single-center retrospective study of KTRs who underwent KTx from 2017 to 2020 was performed. We reviewed the prevalence of CV risk factors and the results of the pre-KTx CV workup which was derived from the American Heart Association guidelines. Results. We included 254 KTRs. The mean age was 43.1 ± 15.9 years, and 55.5% were men and 79.5% were living-donor KTRs. Pre-emptive KTx was 9.8%, peritoneal dialysis was 11.8%, and hemodialysis was 78.3% (arteriovenous fistula: 33.1% versus hemodialysis catheter: 66.9%). The mean dialysis vintage was 4.8 ± 3.3 years for deceased-donor KTRs versus 2.4 ± 2.6 years for living-donor KTRs. CV risk factors were hypertension: 76%, diabetes: 40.6% (type 1 : 25.2% versus type 2 : 74.7%), hyperlipidemia (low-density lipoprotein >2.6 mmol/L): 40.2%, coronary artery disease (CAD): 12.6%, smoking: 9.1%, peripheral vascular disease: 2.8%, and cerebral vascular disease: 2.4%. The prevalence of obesity stage 1 was 19.7% and obesity stage 2 was 4%. Left ventricular hypertrophy was present in 38.5%. The ejection fraction was abnormal (<55%) in 22%. Abnormal wall motion was present in 34 patients (13.4%). A cardiac (PET-CT) stress test was conducted on 129 patients (50.8%) which showed abnormal perfusion in 37 patients (28.7%). Out of those who required PET-CT, 18.6% had a coronary artery calcium scoring (CACS) of more than 400, 41.8% had a CACS of zero, 29.4% had a CACS of 1–100, and 14.7% had a CACS of 100–400. Coronary angiogram was required in only 41 patients (16.1%), 12 (29.3%) required coronary interventions, 25 (61%) were treated medically, and 4 (9.8%) did not have any CAD. CT scans of pelvic arteries were performed in 118 patients (46.5%). It showed moderate or severe calcifications in only 7 patients (5.9%), whereas it was normal in 97 patients (82.2%), or it showed only mild calcifications in 14 patients (11.9%). Conclusion. This study outlines the prevalence of CV risk factors and the findings of the pretransplant CV workup among KTx candidates who underwent KTx. Multicenter national studies will be helpful to validate the generalizability of these findings.

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Section: Discussionmentioning

confidence: 99%

“…However, pre-KTx dialysis duration may be quite long even when planned with a living donor [ 35 ]. The advantages of protecting these patients from AVF creation must be carefully evaluated against catheter-related risks [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Findings of Cardiovascular Workup of Kidney Transplant Candidates: A Retrospective Study of a Single-Center in Saudi Arabia

Arabi,

Tawhari,

Al Rajih

et al. 2023

International Journal of Nephrology

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“…34 However, pre-KTx dialysis duration may be quite long even when planned with LD. 35 Advantages from protecting these patients from AVF creation must be carefully evaluated against catheter-related risks. 35 As mentioned earlier, the results of CV workup of KTRs candidates vary among centers, based on the studied population, and the screening protocol.…”

Section: Discussionmentioning

confidence: 99%

“…35 Advantages from protecting these patients from AVF creation must be carefully evaluated against catheter-related risks. 35 As mentioned earlier, the results of CV workup of KTRs candidates vary among centers, based on the studied population, and the screening protocol. The CV risk assessment of KTx candidates at our center is derived mostly from AHA guidelines 2013.…”

Section: Discussionmentioning

confidence: 99%

Findings of Cardiovascular Workup of Kidney Transplant Candidates: A Retrospective Study of a Single-Center in Saudi Arabia

Arabi,

Tawhari,

Rajih

et al. 2023

Preprint

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Background: There are limited data about the prevalence of cardiovascular (CV) risk factors and the findings of CV workup among kidney transplant (KTx) recipients (KTRs) in Saudi Arabia. Method: A single-center retrospective study of KTRs who underwent KTx from 2017 to 2020. We reviewed the prevalence of CV risk factors and the results of the pre-KTx CV workup which was derived from the American Heart Association guidelines. Results: We included 254 KTRs. The mean age was 43.1±15.9 years, 55.5% were men and 79.5% were living-donor KTRs. Pre-emptive KTx was 9.8%, peritoneal dialysis: 11.8% and hemodialysis: 78.3% (arteriovenous fistula: 33.1% versus hemodialysis catheter: 66.9%). Mean dialysis vintage was 4.8±3.3 years for deceased-donor KTRs versus 2.4±2.6 years for living-donor KTRs. CV risk factors were hypertension: 76%, diabetes: 40.6% (type 1: 25.2% versus type 2: 74.7%), hyperlipemia (low-density lipoprotein> 2.6 mmol/L): 40.2%, coronary artery disease (CAD): 12.6%, smoking: 9.1%, peripheral vascular disease: 2.8%, and cerebral vascular disease: 2.4%. The prevalence of obesity stage 1 was 19.7% and obesity stage 2 was 4%. Left ventricular hypertrophy was present in 38.5%. Ejection fraction was abnormal (<55%) in 22%. Abnormal wall motion was present in 34 patients (13.4%). Cardiac (PET-CT) stress test was indicated in 129 patients (50.8%) and showed abnormal perfusion in 37 patients (28.7%). Out of those who required PET-CT, 18.6% had coronary artery calcium scoring (CACS) more than 400, 41.8 had CACS of zero, 29.4% had CACS of 1-100, and 14.7% had CACS of 100-400. Coronary angiogram was required in only 41 patients (16.1%), 12 (29.3%) required coronary interventions, 25 (61%) were treated medically, and 4 (9.8%) did not have any CAD. CT scans of pelvic arteries were performed in 118 patients (46.5%). It showed moderate or severe calcifications in only 7 patients (5.9%), whereas it was normal in 97 patients (82.2%), or it showed only mild calcifications in 14 patients (11.9%). Conclusion: This study outlines the prevalence of CV risk factors and the findings of the pretransplant CV workup among KTx candidates who underwent KTx. Multicenter national studies will be helpful to validate the generalizability of these findings.

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Early Kidney Transplantation or Conversion to Peritoneal Dialysis after First-Time Arteriovenous Access Creation

Zhu,

Farber,

King

et al. 2024

Annals of Vascular Surgery

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Practice patterns of dialysis access and outcomes in patients wait-listed early for kidney transplantation

Cited by 4 publications

References 40 publications

Findings of Cardiovascular Workup of Kidney Transplant Candidates: A Retrospective Study of a Single-Center in Saudi Arabia

Findings of Cardiovascular Workup of Kidney Transplant Candidates: A Retrospective Study of a Single-Center in Saudi Arabia

Findings of Cardiovascular Workup of Kidney Transplant Candidates: A Retrospective Study of a Single-Center in Saudi Arabia

Early Kidney Transplantation or Conversion to Peritoneal Dialysis after First-Time Arteriovenous Access Creation

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