Introduction
Patients with end stage renal disease (ESRD) have a cardiovascular
mortality about 15-30 times the general population and this is
dramatically reduced by renal transplantation (1-2). Dobutamine stress
echocardiography (DSE) is commonly performed in the preoperative cardiac
evaluation of this high-risk population before renal transplantation.
Hypertensive response during DSE defined as stress induced systolic
blood pressure of >220 mmHg or diastolic blood pressure of
>110 mmHg occurs in about 1-5% of DSE studies (3). But
this phenomenon seems to be more frequent in patients with renal
failure. However, its precise frequency, predictors, diagnostic and
clinical implications in ESRD population are unknown. We investigated
these questions in a large consecutive series of patients from a
tertiary care center undergoing dobutamine stress echocardiography
before listing for renal transplantation.