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World J Transplant. Dec 24, 2015; 5(4): 276-286
Published online Dec 24, 2015. doi: 10.5500/wjt.v5.i4.276
Screening for cardiovascular disease before kidney transplantation
Sneha Palepu, G V Ramesh Prasad
Sneha Palepu, Renal Transplant Program, St. Michael’s Hospital, University of Toronto, Toronto, ON M5C 2T2, Canada
G V Ramesh Prasad, Division of Nephrology, Department of Medicine, University of Toronto, Toronto, ON M5C 2T2, Canada
Author contributions: Palepu S and Prasad GVR contributed equally to the literature review and writing the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare in relation to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: G V Ramesh Prasad, MBBS, MSc, MA, FRCPC, FACP, FASN, Associate Professor of Medicine, Division of Nephrology, Department of Medicine, University of Toronto, 61 Queen Street East, 9th Floor, Toronto, ON M5C 2T2, Canada. prasadr@smh.ca
Telephone: +1-416-8673722 Fax: +1-416-8673709
Received: June 29, 2015
Peer-review started: July 2, 2015
First decision: September 30, 2015
Revised: October 31, 2015
Accepted: November 24, 2015
Article in press: November 25, 2015
Published online: December 24, 2015
Processing time: 177 Days and 0.9 Hours
Core Tip

Core tip: Transplant candidates on dialysis are more likely to be screened for heart disease than those not being considered for transplantation. Screening in this population is driven by complex and competing priorities. Clinicians have a duty both to the candidate’s survival and to allograft success. Few cardiovascular disease conditions detected by screening require immediate attention; there is a trade-off between the risks from a given procedure that are immediate and the benefits from that procedure which are more remote. It is important to clearly distinguish coronary artery disease from other cardiac conditions to help guide the selection of appropriate diagnostic strategies.