Document Detail


Ischaemia imaging in type 2 diabetic kidney transplant candidates--is coronary angiography essential?
MedLine Citation:
PMID:  17550928     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary artery disease (CAD) remains the leading cause of death in type 2 diabetes mellitus (DM) patients undergoing renal transplantation. There is a high prevalence of silent CAD in these patients. Controversy exists regarding the role of dobutamine stress echocardiography (DSE) in detection of CAD. Our purpose was to compare DSE with coronary angiography (CA) for the detection of CAD in type 2 diabetic patients undergoing evaluation for renal transplantation. METHODS: Forty (36 male, four female) type 2 diabetic patients with end-stage renal disease (ESRD) were subjected to DSE followed by CA as a part of their pre-renal transplant evaluation. The ability of DSE to predict 70% stenosis in one or more coronary arteries as determined by CA was evaluated. Mean age of the patients was 49.2 +/- 5 years (range 39-60 years). RESULTS: DSE was positive in 10 (25%) patients, while 19 patients (48%) had a more than 70% lesion in at least one epicardial vessel on CA (six patients had single vessel, three had double vessel and 10 had triple vessel disease). The sensitivity and specificity in identifying CAD was 47.3 and 95.2%, respectively, while positive predictive value and negative predictive value was 90% and 66%. Accuracy of DSE was 72.5%. All four patients with diffuse diabetic coronary artery disease had negative DSE. CONCLUSION: DSE is a poor predictor of coronary artery disease in type 2 DM patients being evaluated for renal transplantation. CA should be included in evaluation of type 2 diabetic patients who are renal transplant candidates.
Authors:
Sishir Gang; Manish Dabhi; Mohan Manohar Rajapurkar
Related Documents :
18829238 - Efficacy of protected renal artery primary stenting in the solitary functioning kidney.
831958 - Segmental dearterialization in penetrating renal trauma.
7944048 - Orthotopic ex vivo renal artery reconstruction.
16904548 - Detection of transplant coronary artery disease using multidetector computed tomography...
18294158 - Diagnostic accuracy of measurement methods to assess non-adherence to immunosuppressive...
16634888 - Skin lesions in adult liver transplant recipients: a study of 100 consecutive patients.
Publication Detail:
Type:  Journal Article     Date:  2007-06-05
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  22     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-26     Completed Date:  2007-11-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2334-8     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Muljibhai Patel Urological Hospital, Dr V. V. Desai Road, Nadiad, 387001 Gujarat, India. sishirgang@hotmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / pharmacology
Adult
Coronary Angiography / methods*
Diabetes Mellitus, Type 2 / therapy*
Dobutamine / pharmacology
Echocardiography, Stress / methods
Electrocardiography / methods
Female
Humans
Ischemia / pathology*
Kidney Transplantation / methods*
Male
Middle Aged
Myocardial Ischemia / pathology
Reproducibility of Results
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Review on uraemic solutes II--variability in reported concentrations: causes and consequences.
Next Document:  Ionic dialysance and the assessment of Kt/V: the influence of different estimates of V on method agr...