Hospitalized valvular heart disease in patients on renal transplant waiting list: incidence, clinical correlates and outcomes.
Clin Nephrol
; 59(2): 79-87, 2003 Feb.
Article
em En
| MEDLINE
| ID: mdl-12608550
ABSTRACT
BACKGROUND:
Patients with ESRD are at increased risk for heart valve calcification. It has not been established whether hospitalized valvular heart disease (VHD) is a substantial barrier to renal transplantation (RT) after transplant listing, or whether VHD progresses after RT.METHODS:
Using data from the USRDS, we studied 35,215 patients with ESRD enrolled on the renal transplant waiting list from July 1994 to June 1997. Cox non-proportional hazards regression models were used to calculate adjusted, time-dependent hazard ratios (HR) for RT and VHD.RESULTS:
In comparison to maintenance dialysis (2.2/1,000 person years), RT was independently associated with a lower hazard for hospitalization for VHD (0.7/1,000 person years, HR 0.28, 95% confidence interval 0.17 - 0.47). Renal transplant recipients had much lower rates of VHD after transplant than before (rate ratio (RR) 0.49, 95% Cl 0.47 - 0.52). Patients with VHD were significantly less likely to receive RT (adjusted rate for RT 0.38, 95% CI 0.20 - 0.45) but patients who received valve replacement surgeries (VRS) were not affected (adjusted rate for RT 1.10, 95% CI 0.52 - 2.32, not significant).CONCLUSIONS:
VHD is an uncommon but serious barrier to RT after listing, while VRS is not a significant barrier to RT. Established VHD does not appear to worsen after RT. Clinicians should consider giving increased attention to the detection and treatment of VHD during the pre-transplant evaluation.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Listas de Espera
/
Transplante de Rim
/
Doenças das Valvas Cardíacas
/
Hospitalização
/
Falência Renal Crônica
Tipo de estudo:
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Clin Nephrol
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Estados Unidos