Predictors of survival in patients with end-stage renal disease evaluated for kidney transplantation

disease (ESRD). This study examined the all-cause mortality in 3,698 patients with ESRD evaluated for kidney transplantation at our institution from 2001 to 2004. Mean age for the cohort was 48 +/- 12 years, and 42% were women. Stress myocardial perfusion imaging was done in 2,207 patients (60%) and coronary angiography in 261) patients (7%). There were 622 deaths (17%) during a mean follow-up period of 30 +/- 15 months. The presence and severity of coronary disease on angiography was not predictive of survival. Coronary revascularization did not impact survival (p = 0.6) except in patients with 3-vessel disease (p = 0.05). The best predictor of death was left ventricular ejection fraction, measured by gated myocardial perfusion imaging, with 2.7% mortality increase for each 1% ejection fraction decrease. In conclusion, left ventricular ejection fraction is a strong predictor of survival in patients with ESRD, awaiting renal transplantation. Strategies to improve cardiac function or earlier renal transplantation deserve further studies. (c) 2007 Elsevier Inc. All rights reserved.