Asymptomatic coronary artery disease: angiography in diabetic patients before renal transplantation. Relation of findings to postoperative survival.
Twenty-one juvenile-onset diabetic patients with azotemic nephropathy underwent coronary angiography and left ventriculography before renal transplantation or chronic hemodialysis. Two-year survival of 12 patients with no coronary artery disease (group A) was 88% compared to 22% for nine patients with coronary artery disease (group B) (P less than 0.025). Each group A patient underwent renal transplantation (nine live-related, three cadaveric). Four group B patients received cadaveric allografts. Among group A patients two cadaveric allografts functioned while in group B patients no allografts were successful. In the absence of coronary artery disease, results were similar to those reported for nondiabetic persons. In the presence of coronary artery disease, 62% of the deaths were due to myocardial infarction or sudden death. These results indicate that atherosclerotic coronary artery disease is a major determinant of survival in diabetic patients undergoing chronic hemodialysis or renal transplantation.
D000328:Adult; D000792:Angiography; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D003928:Diabetic Nephropathies / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D011446:Prospective Studies; D006435:Renal Dialysis; D014184:Transplantation, Homologous