242.9: Do the Findings of Pre-transplant Cardiovascular Imaging Corollate With Having Persistent Hyperparathyroidism at Year Post Renal Transplantation?

Abstract

Background: Hyperparathyroidism is common in chronic kidney disease, and it can persist post renal transplantation. It is unknown whether the findings of cardiovascular imaging pre- transplantation corollate with the persistence of hyperparathyroidism (persHPTH) at one-year post-renal transplantation. Method: A single center retrospective study of renal transplant candidates from January 2017 to May 2020. We collected patients’ demographics, cardiovascular risk factors, the findings of pre- transplant cardiovascular imaging (echo, nuclear cardiac perfusion stress test, calcium scoring, cardiac catheterization results and the degree of calcification/atherosclerosis of pelvic arteries on screening pelvic CT scan). We also collected iPTH values [at baseline (before transplant), 1- 6 months, 6-12 months, and 12-24 months post transplantation]. We defined persHPTH as iPTH ≥ 25.5 pmol/L after 12 months post kidney transplantation (normal= 12.73 pmol/L). Results: 287 renal transplant recipients were included. 74% were ≥ 30 years, 58% were men and 80% were living-donor kidney recipients. Preemptive transplantation was 10.1%, PD: 11.5% and HD: 78.4% (AVF: 42% versus Permcath: 58%). Dialysis ventage was 4.8±3.3 years for deceased donor kidney transplantation (DDKT) versus 2.4±2.6 years for living donor kidney transplantation (LKT). The prevalence of persHPTH was [n = 47 (16.4%)]. There were no association between persHPTH and the findings of pre- transplant cardiovascular imaging including echo findings (EF, LVH and abnormal wall motion), cardiac nuclear perfusion stress test (cardiac PET), cardiac catheterization, calcification/atherosclerosis of pelvic arteries seen on screening pelvic CT scan. However, the presence of calcium scoring ≥ 400 on pre -transplant cardiac PET scan was associated with higher incidence of persHPTH at 12 months post renal transplantation (37% versus 13.1%; P: 0.013). Conclusion: There was no association between the incidence of persHPTH post-renal transplant and pre-transplant cardiovascular imaging. However, higher calcium scoring PET scan (> 400) are associated with higher incidence of persHPTH at 12 months post renal transplantation.