Role of a cardio-renal multi-disciplinary team meeting in managing cardiovascular risk in patients on kidney transplant waitlists

Clin Transplant. 2020 Nov;34(11):e14061. doi: 10.1111/ctr.14061. Epub 2020 Aug 27.


Background: Waitlisted kidney transplant patients suffer from excess cardiovascular events. The benefits of regular cardiac investigations, potentially harmful and expensive, are unknown. We investigate the effectiveness of a cardio-renal MDT in managing high cardiovascular risk waitlisted transplant patients to prevent events and enable transplantation.

Methods: Clinical outcomes in waitlisted transplant candidates managed by our cardio-renal MDT protocol were compared against our standard protocol. Data compared include the transplantation, event, and death rates, cost of cardiac investigations and procedures, and graft, patient survival, and re-hospitalization rates in transplanted patients.

Results: 207 patients were studied (81 standard, 126 cardio-renal MDT). Over 2.7 years, the cardio-renal MDT protocol transplanted more patients than the standard group (35% vs 21%; P = .02). The managing cost per patient per year was higher in the standard group (£692 vs £610). This was driven by more echocardiograms and more tests per patient in the standard group (P < .01). There was no difference in adverse events or death. There was no difference in re-hospitalization, graft or patient survival rate in transplanted patients.

Conclusions: Our cardio-renal MDT was effective in managing high-risk kidney transplant candidates with greater rates of transplantation and low rates of events at a lower cost.

Keywords: cardio-renal syndrome; cardiovascular disease; chronic kidney disease; end-stage renal disease; kidney transplantation.

MeSH terms

  • Cardiovascular Diseases* / etiology
  • Cardiovascular Diseases* / prevention & control
  • Graft Survival
  • Heart Disease Risk Factors
  • Humans
  • Kidney Failure, Chronic* / surgery
  • Kidney Transplantation*
  • Risk Factors
  • Survival Rate