Journal of the American Society of Nephrology
2008 JASN IMPACT FACTOR 7.505 HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP 
    advanced
CURRENT ISSUE ARCHIVES JASN Express ONLINE SUBMISSION


Published ahead of print on March 27, 2008
Journal of the American Society of Nephrology
© 2008 American Society of Nephrology
doi: 10.1681/ASN.2007040503
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
ASN.2007040503v1
19/6/1191    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by de Mattos, A. M.
Right arrow Articles by Iskandrian, A. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by de Mattos, A. M.
Right arrow Articles by Iskandrian, A. E.
Related Collections
Right arrowRelated Article

Received April 24, 2007
Accepted on November 6, 2007

CLINICAL EPIDEMIOLOGY

Systolic Dysfunction Portends Increased Mortality among Those Waiting for Renal Transplant

Angelo M. de Mattos *1, Andrew Siedlecki *, Robert S. Gaston *, Gilbert J. Perry {dagger}, Bruce A. Julian *, Clifton E. Kew II *, Mark H. Deierhoi {ddagger}, Carlton Young {ddagger}, John J. Curtis *, and Ami E. Iskandrian {dagger}

Divisions of *Nephrology, and {dagger}Cardiology, {ddagger}Transplant Surgery, University of Alabama at Birmingham, Birmingham, Alabama


1 To whom correspondence should be addressed. E-mail: angelo.demattos{at}ucdmc.ucdavis.edu.


   Abstract

Individuals waiting for a renal transplant experience excessive cardiovascular mortality, which is not fully explained by the prevalence of ischemic heart disease in this population. Overt heart failure is known to increase the mortality of patients with ESRD, but the impact of lesser degrees of ventricular systolic dysfunction is unknown. For examination of the association between left ventricular ejection fraction (LVEF) and mortality of renal transplant candidates, the records of 2718 patients evaluated for transplantation at one institution were reviewed. During 6355 patient-years (median 27 mo) of follow-up, 681 deaths occurred. Patients with systolic dysfunction (LVEF ≤0.40) had significantly lower survival than those with higher systolic function (median 49 ± 3.1 versus 72 ± 4.0 mo; P < 0.001) but had similar survival to patients with ischemia (48 ± 2.5 mo). Multivariate modeling showed that those with systolic dysfunction were nearly twice as likely to die as those with normal systolic function, adjusted for risk factors including diabetes, left ventricular hypertrophy, and ischemia (adjusted hazard ratio 1.7; 95% confidence interval 1.43 to 2.07). In addition, a graded, reverse association between LVEF and mortality was identified. In conclusion, systolic dysfunction is strongly associated with mortality, in a graded manner, in renal transplant candidates.


Related Article

This Month's Highlights
J. Am. Soc. Nephrol. 2008 19: A4. [Full Text] [PDF]



This article has been cited by other articles:


Home page
J Am Coll CardiolHome page
F. G. Hage, R. Venkataraman, G. J. Zoghbi, G. J. Perry, A. M. DeMattos, and A. E. Iskandrian
The scope of coronary heart disease in patients with chronic kidney disease.
J. Am. Coll. Cardiol., June 9, 2009; 53(23): 2129 - 2140.
[Abstract] [Full Text] [PDF]




HOME CURRENT ISSUE ARCHIVES JASN Express ONLINE SUBMISSION AUTHOR INFO
EDITORIAL BOARD SUBSCRIBE FEEDBACK ALERTS HELP