Belal Amer Ashaab, Santos Alfonso Hernandez, Kazory Amir
Department of Medicine, Division of Nephrology, University of Florida College of Medicine, Gainesville, FL 32610, United States.
Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL 32608, United States.
World J Transplant. 2024 Dec 18;14(4):96017. doi: 10.5500/wjt.v14.i4.96017.
Patients with advanced kidney disease are at elevated risk of developing heart failure and appropriate risk stratification is important to permit them to receive kidney transplantation. The American Heart Association and American College of Cardiology joint statement provides guidance on risk stratification for the major cause of heart failure for these patients in its recommendations for coronary heart disease. Herein we provide an overview of the available literature on risk stratification for nonischemic heart failure and functional heart disease states such as pulmonary hypertension. Many of these options for optimizing these patients before transplant include optimizing their volume status, often with more aggressive ultrafiltration. Kidney transplantation remains the treatment of choice for patients with advanced kidney disease and cardiac disease, the correction of the azotemic substances with kidney transplantation has been associated with improved survival than remaining on dialysis long-term. The findings in the studies reviewed here are expected to help clinicians refine current strategies for evaluating potential kidney transplant recipients.
晚期肾病患者发生心力衰竭的风险升高，进行适当的风险分层对于他们接受肾移植很重要。美国心脏协会和美国心脏病学会的联合声明在其关于冠心病的建议中，为这些患者心力衰竭的主要病因风险分层提供了指导。在此，我们概述了关于非缺血性心力衰竭和功能性心脏病状态（如肺动脉高压）风险分层的现有文献。在移植前优化这些患者状况的许多选择包括优化其容量状态，通常采用更积极的超滤。肾移植仍然是晚期肾病和心脏病患者的首选治疗方法，与长期维持透析相比，肾移植纠正氮质血症物质与生存率提高相关。本文综述研究中的发现有望帮助临床医生完善当前评估潜在肾移植受者的策略。
