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.