Predictors of positive thallium 201 single photon emission computed tomography in patients of end stage renal disease.

OBJECTIVES To study coronary artery disease (CAD) risk factors predicting positive thallium-201 single photon emission computed tomography (SPECT) indicating underlying CAD among patients of end stage renal disease. PLACE AND DESIGN: This cross-sectional (analytical) study was done at Department of Cardiology, Punjab Institute of Cardiology, from April 2004 to Dec 2007. METHODS One hundred consecutive patients with ESRD undergoing thallium SPECT as a routine screening test before renal transplant were studied. Dipyridamole thallium SPECT was performed in patients who were unable to exercise. RESULTS Thallium SPECT was positive in 47 (47%) cases. There were significant differences in age, underlying diabetic nephropathy and total cholesterol levels among patients positive and negative on thallium SPECT. Among the risk factors age and underlying diabetic nephropathy were significantly associated (p < 0.05) with a positive thallium SPECT in patients with ESRD. CONCLUSION Positive thallium SPECT indicating underlying CAD was observed in a significant number of patients with ESRD awaiting renal transplant. Presence of advanced age and underlying diabetic nephropathy predict a positive thallium SPECT in this population.