Table 2.
Cardiac stress investigations in the normal renal function versus advanced chronic kidney disease (CKD) patients.
| Cardiac stress modalities | Sensitivity (%) |
Specificity (%) |
Issues | ||
|---|---|---|---|---|---|
| Normal renal function | CKD | Normal renal function | CKD | ||
| Exercise stress ECG | 68 (52–84) | 36 (21–54) | 77 (60–94) | 91 (83–96) | Reduced exercise capacity (deconditioning) |
| Impaired chronotropic response | |||||
| Abnormal baseline ECG and left ventricular hypertrophy | |||||
| Exercise stress echocardiography | 71–97 | Possibly similar to DSE | 64–90 | Possibly similar to DSE | Reduced exercise capacity (deconditioning) |
| Impaired chronotropic response | |||||
| Abnormal baseline ECG and left ventricular hypertrophy | |||||
| Pharmacological stress echocardiography | 86 (78–91) | 80 (64–90) | 86 (75–89) | 89 (79–94) | Blunted chronotropic response |
| Left ventricular hypertrophy | |||||
| Microvascular disease potentially can be missed | |||||
| Myocardial perfusion scintigraphy | 89 | 69 (48–85) | 75 | 77 (59–89) | False negative results in multi-vessel disease due to balanced ischemia |
| Dobutamine stress CMR | Research ongoing | Research ongoing | Blunted chronotropic response | ||
| Microvascular disease potentially can be missed | |||||