Kidney Week 2025 Early Program - Care of Kidney Transplant Candidates and Recipients-Pretransplant Cardiac Testing: When Less Is More

Video Transcription

Video Summary

The speaker discusses whether routine pre-transplant cardiac testing for asymptomatic kidney transplant candidates is overused. Guidelines (ACC/AHA) suggest no testing for patients with good functional capacity, yet most transplant centers still order stress tests, despite lack of consensus among major organizations. Evidence such as the ISCHEMIA-CKD trial shows invasive strategies in high-risk CKD patients with ischemia do not improve outcomes and may cause harm. Meta-analyses also find few severe coronary lesions despite frequent angiography. The talk argues for “less is more,” using better functional assessment (e.g., MET questionnaires or cardiopulmonary exercise testing) to safely avoid unnecessary stress tests, costs, and potential downstream harm.

Asset Subtitle

Samira Farouk

Meta Tag

Module TRX

Speaker Samira Farouk

Keywords

pre-transplant cardiac testing

asymptomatic kidney transplant candidates

ACC/AHA guidelines functional capacity

ISCHEMIA-CKD trial invasive strategy outcomes

cardiopulmonary exercise testing MET assessment