Pretransplantation Cardiac Workup of the Kidney Transplant Recipient for Coronary Heart Disease

As the prevalence of chronic kidney disease (CKD) increases globally, a greater number of CKD patients are surviving to become end-stage kidney disease (ESKD) and avail kidney transplantation as means of therapy. Furthermore, with the global mismatch of demand and supply of organs, a large number of ESKD patients remain on the waitlist of deceased donor renal transplantation for longer times. The risk of cardiovascular diseases (CVD) rises exponentially with advancing stages of CKD. The elevated risk in these patients also accounts for CVD as the leading cause of mortality in these patients as compared to the underlying kidney disease. Wherein, there is ample justification for pretransplantation screening of a potential transplantation recipient, the benefits of such screening remain unproven in literature. In this narrative review, we discuss the uncertainties associated with pretransplantation cardiac screening including the appropriate tests, the interpretation of their results, and the complications of the same and deal with the cardiac screening pertaining predominantly to coronary heart disease.