Korean J Nephrol.  2005 May;24(3):407-413.

Diagnostic Noninvasive Tests for Coronary Artery Disease in Chronic Renal Failure Patients

• Bae WK
• Kim OK
• Shin MH
• Woo H
• Lee YC
• Cho YW
• Lee YK
• Cho MS
• Ma SK
• Kim SW
• Kim NH
• Jeong MH
• Choi KC

Abstract

BACKGROUND
As ischemic heart disease is the major cause of death in chronic renal failure patients, screening tests are clinically important. Although coronary angiography is considered the gold standard for the diagnosis of coronary artery disease, other noninvasive tests are usually used to avoid this potentially dangerous and costly procedure. METHODS: We retrospectively determined the sensitivity, specificity, and positive and negative predictive values for electrocardiography, echocardiography, cardiac enzyme determination, and Technetium 99m tetrofosmin (TF) single photon emission computed tomography (SPECT) in 61 chronic renal failure patients who underwent coronary angiography. RESULTS: Nineteen patients (31.1%) were undergoing chronic hemodialysis, seven patients (11.4%) were undergoing peritoneal dialysis, and thirty five patients (57.3%) were undergoing conservative treatment. 99mTc SPECT had a sensitivity of 96% and specificity of 19%. Although echocardiography and tronponin-T had a relatively lower sensitivity of 69 % and 56% than 99mTc SPECT, they had a higher specificity of 63% and 63%, respectively. 99mTc SPECT had the highest sensitivity of 88% and echocardiography had the highest specificity of 78% in renal replacement group. 99mTc SPECT had the highest sensitivity of 100% and Troponin T had the highest specificity of 71% in conservative treatment group. CONCLUSION: Noninvasive test for coronary artery disease in patients with chronic renal failure, especially 99mTc SPECT is of limited value because of their low specificity, so echocardiography and troponin T may helpful for diagnosing coronary artery disease.

Keyword

Chronic kidney failure; Coronary disease; Troponin; Echocardiography

MeSH Terms

Cause of Death
Coronary Angiography
Coronary Artery Disease*
Coronary Disease
Coronary Vessels*
Diagnosis
Echocardiography
Electrocardiography
Humans
Kidney Failure, Chronic*
Mass Screening
Myocardial Ischemia
Peritoneal Dialysis
Renal Dialysis
Retrospective Studies
Sensitivity and Specificity
Technetium
Tomography, Emission-Computed, Single-Photon
Troponin
Troponin T
Technetium
Troponin
Troponin T