Screening for cardiovascular disease before kidney transplantation

Figure 1 Suggested pre-transplant screening algorithm for cardiovascular disease. ¹Diabetes mellitus, prior CVD, > 1 year on dialysis, LVH, age > 60 years, smoking, hypertension, and dyslipidemia; ²Proceed to transplantation with standard screening and frequency of testing [for patients with no abnormalities at start, standard frequency is evaluation once dry weight is achieved (1-3 mo) and prior to transplantation date]; ³Abnormalities that pose limited threat to the success of the allograft and patient’s health; ⁴Per cardiologist recommendation. CVD: Cardiovascular disease; MPS: Myocardial perfusion scintigraphy; DSE: Dobutamine stress echocardiography; LVH: Left ventricular hypertrophy; METS: Metabolic equivalents.