Asymptomatic Coronary Artery Disease: Angiography in Diabetic Patients Before Renal Transplantation

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Abstract
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 9 patients with coronary artery disease (group B) (P < 0.025). Each group A patient underwent renal transplantation (9 live-related, 3 cadaveric). Four group B patients received cadaveric allografts. Among group A patients 2 cadaveric allografts functioned while in group B patients no allografts were successful. In the absence of coronary artery disease, result 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. Atherosclerotic coronary artery disease evidently is a major determinant of survival in diabetic patients undergoing chronic hemodialysis or renal transplantation.