We report the prevalence of coronary artery disease (CAD) in asymptomatic patients with end-stage kidney disease (ESKD) on hemodialysis and explore the best revascularization strategies prior to kidney transplantation. This is a retrospective single-center study, which included all patients who were candidates for kidney transplantation and underwent coronary angiography between 2003 and 2018. All included patients underwent coronary angiography without noninvasive testing and were asymptomatic cardiac-wise. Out of the 368 patients with ESRD, 45% had coronary vessel disease, 17% had 3-vessel disease, 11% had 2-vessel disease, 5.2% had significant left main artery narrowing, and 17% had single-vessel disease. Patients with 3-vessel disease had the worst survival rate at 5 and 10 years. The patients with significant 3-vessel disease or left main artery involvement underwent revascularization; 19% underwent coronary artery bypass grafting, 5% had stenting of the coronary arteries, and 4.7% were on maximal medical therapy. The patients who underwent stenting had a better survival than those on medical therapy, but the difference was not significant (P = .445). Our findings reflect a high prevalence of CAD in patients with ESKD. There is a need for further studies to evaluate benefits of cardiovascular screening in this patient population.

中文翻译：

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肾移植前无症状终末期肾脏疾病的无症状患者常规冠状动脉造影的结果。

我们报告无症状终末期肾脏疾病（ESKD）的无症状患者在血液透析中的冠状动脉疾病（CAD）的患病率，并探讨肾脏移植之前的最佳血运重建策略。这是一项回顾性单中心研究，其中包括所有在2003年至2018年之间进行肾脏移植并接受了冠状动脉造影术的患者。所有受试者均接受了未经无创性检查且无症状的心脏冠状动脉造影术。在368例ESRD患者中，45％患有冠状动脉疾病，17％患有3血管疾病，11％患有2血管疾病，5.2％患有显着的左主动脉狭窄，17％患有单血管疾病。3血管疾病患者的5年和10年生存率最差。患有严重三支血管疾病或左主动脉受累的患者进行了血运重建；19％接受了冠状动脉搭桥术，5％进行了冠状动脉支架置入术，4.7％接受了最大的药物治疗。接受支架置入术的患者比接受药物治疗的患者具有更好的生存率，但差异无统计学意义（P = .445）。我们的发现反映了ESKD患者中CAD的高患病率。需要进行进一步的研究以评估该患者人群进行心血管筛查的益处。但差异不显着（P = .445）。我们的发现反映了ESKD患者中CAD的高患病率。需要进行进一步的研究以评估该患者人群进行心血管筛查的益处。但差异不显着（P = .445）。我们的发现反映了ESKD患者中CAD的高患病率。需要进行进一步的研究以评估该患者人群进行心血管筛查的益处。