title: Evaluation of Carotid Ultrasonography Screening Among Kidney Transplant Candidates: A Single-Center, Retrospective Study.
abstract: BACKGROUND
  Kidney transplant candidates undergo rigorous testing prior to clearance for transplantation. Because kidney transplant candidates may be at increased risk for carotid artery stenosis because of arteriosclerosis and atherosclerosis secondary to hypertension, vascular calcification, and diabetes, carotid ultrasound is often performed with the intent of preventing a cerebrovascular accident in the perioperative or posttransplant period. To our knowledge, there has not been a study investigating the utility of screening carotid ultrasonography in pretransplant candidates. The purpose of the present study was to investigate the yield of carotid ultrasonography in end-stage renal disease patients, at high risk for having clinically significant vascular disease evaluated at our center for kidney transplantation during the years 2009 to 2014.
  
  
  METHODS
  Data for carotid ultrasound findings and risk factors for carotid artery disease were extracted from the medical records.
  
  
  RESULTS
  A total of 882 patients were included in our study of which only 13 patients (1.47% of the cohort) had significant carotid artery stenosis (>70%) on ultrasound testing. Using multiple logistic regression on the outcome of carotid stenosis, congestive heart failure (adjusted odds ratio, 5.2), and peripheral vascular disease (adjusted odds ratio, 4.4) were positively associated with carotid stenosis.
  
  
  CONCLUSIONS
  The prevalence of significant carotid artery stenosis was only 1.47% in our cohort of kidney transplant candidates, and the routine use of carotid ultrasound testing in this population may not be an efficient use of clinical resources. Use of risk factors, such as congestive heart failure or peripheral vascular disease, may identify patients who are more likely to benefit from carotid ultrasonography screening.
authors.affiliation: J. C. Walter Jr. Transplant Center and the Nephrology Program, Department of Medicine, Houston Methodist Hospital, Houston, TX.
authors.forename: Chad W
authors.initials: CW
authors.lastname: Rossitter
authors.affiliation: J. C. Walter Jr. Transplant Center and the Nephrology Program, Department of Medicine, Houston Methodist Hospital, Houston, TX.
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Vigo
authors.affiliation: J. C. Walter Jr. Transplant Center and the Nephrology Program, Department of Medicine, Houston Methodist Hospital, Houston, TX.
authors.forename: Ahmed Osama
authors.initials: AO
authors.lastname: Gaber
authors.affiliation: J. C. Walter Jr. Transplant Center and the Nephrology Program, Department of Medicine, Houston Methodist Hospital, Houston, TX.
authors.forename: Joshua T
authors.initials: JT
authors.lastname: Swan
authors.affiliation: J. C. Walter Jr. Transplant Center and the Nephrology Program, Department of Medicine, Houston Methodist Hospital, Houston, TX.
authors.forename: Wadi N
authors.initials: WN
authors.lastname: Suki