Patients with diabetic nephropathy who are candidates for kidney or kidney- pancreas transplantation should be screened routinely with coronary angiography, researchers in Norway conclude.


They retrospectively studied 155 such transplant candidates (61% with type 1 diabetes and 39% with type 2 diabetes), of whom 69 (45%) had significant asymptomatic coronary artery stenoses (CAS) identified with coronary angiography. Thirty-nine of these patients (57%) underwent revascularization.

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The researchers, led by Bartlomiej J. Witczak, MD, of the University of Oslo, defined significant CAS as a luminal diameter stenosis greater than 50% in epicardial vessels more than 1.5 mm in diameter. Angina pectoris was present in 17% of these patients. Age was the only independent risk factor significantly associated with CAS. No patient under the age of 35 years had significant CAS. Thirty-four percent of patients had a history of heart disease.


The type 1 and 2 diabetes pa-tients had a mean age of 46 and 58 years, respectively.