Hidden heart condition increases the risk of death in patients waiting for kidney transplants

May 15, 2008

An often asymptomatic condition—systolic dysfunction, or decreased pumping of the heart—poses an increased risk of death for patients on kidney transplant waiting lists, according to a study appearing in the June 2008 issue of the Journal of the American Society Nephrology (JASN). The findings reveal that a clinical indicator beyond well-known risk factors for cardiovascular mortality should be considered when caring for patients waiting for kidney donations. The study also suggests that changes in organ allocation policies may be warranted.

Previous research has shown that patients with chronic kidney disease face an elevated risk of dying from heart conditions, such as cardiac ischemia, which occurs when the heart receives an insufficient supply of blood and oxygen. However, ischemic events do not account for most of the cardiac deaths that have been reported in these patients.

To determine what other heart effects may be playing a role in the deaths of patients with chronic kidney disease, Dr. Angelo M. de Mattos, an associate professor of nephrology at the University of California, Davis, School of Medicine and Medical Center in Sacramento, Calif., and colleagues at the University of Alabama at Birmingham analyzed the records for 2,718 kidney transplant candidates, noting the causes of death in those who died. During the study, 681 patients died during follow-up, which was conducted for a median of 27 months.

The investigators discovered that patients with systolic dysfunction were nearly twice as likely to die as those without this condition. This higher rate of mortality was similar to that seen in patients with cardiac ischemia, the most well-known risk factor for cardiovascular death in patients with chronic kidney disease.

Dr. de Mattos and his team found that death rates for patients with systolic dysfunction who were waiting for kidney transplants were almost six-fold higher than the reported mortality for individuals with systolic dysfunction in the general population.

The study “identifies a subset of the chronic kidney disease population (those with systolic dysfunction, with or without ischemia) at significantly higher mortality risk while awaiting transplantation, where the role of medical interventions and devices such as implantable cardiac defibrillators and pacemakers should be studied,” the authors write. Widely available and minimally invasive testing could be used to help identify those patients with chronic kidney disease who have this mostly asymptomatic, yet life-threatening, condition.

The authors note that if their findings are supported by additional studies, organ distribution policies may need to be redesigned so as to place a priority on these individuals who traditionally have not been considered at an increased risk of death.

The study entitled, “Systolic Dysfunction Portends Increased Mortality among Those Waiting for Renal Transplant,” is available online at jasn.asnjournals.org/ and will appear in print in the June issue of JASN.

Source: American Society of Nephrology

Explore further: Younger newly-diagnosed patients with type 2 diabetes are hit hard by the disease

Related Stories

Younger newly-diagnosed patients with type 2 diabetes are hit hard by the disease

December 12, 2017
The common view of type 2 diabetes as an old person's disease is becoming seriously outdated in step with the increasing number of persons under the age of 45 who develop the disease. New research from Aarhus University now ...

Why simple school sores often lead to heart and kidney disease in Indigenous children

December 11, 2017
Impetigo, also known as school sores, is a highly contagious bacterial skin infection that occurs in children far more frequently than adults. It is one of the most common bacterial infections in children aged two to five ...

Patients with atrial fibrillation at greater risk of death in rural hospitals than urban hospitals

December 11, 2017
Patients with atrial fibrillation (AF) admitted to rural hospitals in the United States have a greater chance of dying during their hospital stay than patients admitted to urban hospitals for the same condition, according ...

Many donor kidneys that are discarded may be suitable for transplantation

December 7, 2017
When researchers examined information on pairs of kidneys from the same donor in which 1 kidney was used but the other was discarded, the kidneys that were used tended to perform well even though they were similar in quality ...

Immunotherapy drug nearly eliminates severe acute graft-versus-host disease

December 9, 2017
Results from a phase 2 clinical trial, presented by Seattle Children's Research Institute at the 59th American Society of Hematology (ASH) Annual Meeting, show that the drug Abatacept (Orencia) nearly eliminated life-threatening ...

Deep insight into the heart

December 8, 2017
By no means are only elderly people at risk from heart diseases. Physically active individuals can also be affected, for example if a seemingly harmless flu bug spreads to the heart muscle. Should this remain undetected and ...

Recommended for you

Estrogen discovery could shed new light on fertility problems

December 12, 2017
Estrogen produced in the brain is necessary for ovulation in monkeys, according to researchers at the University of Wisconsin-Madison who have upended the traditional understanding of the hormonal cascade that leads to release ...

3-D printed microfibers could provide structure for artificially grown body parts

December 12, 2017
Much as a frame provides structural support for a house and the chassis provides strength and shape for a car, a team of Penn State engineers believe they have a way to create the structural framework for growing living tissue ...

Time of day affects severity of autoimmune disease

December 12, 2017
Insights into how the body clock and time of day influence immune responses are revealed today in a study published in leading international journal Nature Communications. Understanding the effect of the interplay between ...

Team identifies DNA element that may cause rare movement disorder

December 11, 2017
A team of Massachusetts General Hospital (MGH) researchers has identified a specific genetic change that may be the cause of a rare but severe neurological disorder called X-linked dystonia parkinsonism (XDP). Occurring only ...

Protein Daple coordinates single-cell and organ-wide directionality in the inner ear

December 11, 2017
Humans inherited the capacity to hear sounds thanks to structures that evolved millions of years ago. Sensory "hair cells" in the inner ear have the amazing ability to convert sound waves into electrical signals and transmit ...

Gene therapy improves immunity in babies with 'bubble boy' disease

December 9, 2017
Early evidence suggests that gene therapy developed at St. Jude Children's Research Hospital will lead to broad protection for infants with the devastating immune disorder X-linked severe combined immunodeficiency disorder. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.