Abstract
Vascular calcification (VC) is linked to post-transplant cardiovascular events and hypercalcemia which may influence kidney graft function in the long term. We aimed to evaluate whether pretransplant aortic arch calcification (AoAC) can predict post-transplant cardiovascular or cerebrovascular events (CVEs), and to assess its association with post-transplant plasma calcium levels and renal function in one-year follow-up. Our single-center observational prospective study enrolled 37 kidney transplant recipients (KTR) without previous history of vascular events. Two radiologists evaluated pretransplant AoAC on chest X-ray as suggested by Ogawa et al. in 2009. Cohen’s kappa coefficient was 0.71. The mismatching results were repeatedly reviewed and resulted in consensus. Carotid-femoral (cfPWV) and carotid-radial pulse wave velocity (crPWV) was measured using applanation tonometry before and one year after transplantation. Patient clinical, biochemical data, and cardiovascular/CVE rate were monitored within 1 year. We found out that eGFR1year correlated with eGFRdischarge and calcium based on hospital discharge data (β = 0.563, p = .004 and β = 51.360, p = .026, respectively). Multivariate linear regression revealed that donor age, donor gender, and recipient eGFRdischarge (R-squared 0.65, p = .002) better predict eGFR1year than AoAC combined with recipient eGFRdischarge (R-squared 0.35, p = .006). During 1-year follow-up, four (10.81%) patients experienced cardiovascular events, which were predicted by PWV ratio (HR 7.549, p = .045), but not related to AoAC score (HR 1.044, p = .158). In conclusion, KTR without previous vascular events have quite low cardiovascular/CVE rate within 1-year follow-up. VC evaluated as AoAC on pretransplant chest X-ray together with recipient eGFRdischarge could be related to kidney function in one-year follow-up.
Highlights
Kidney transplantation (KT) is the most effective treatment method for patients with end-stage renal disease (ESRD) that increases life expectancy [1], but these patients suffer from higher cardiovascular mortality than the general population [2,3]
Recent studies imply that vascular calcification (VC) is an important predictor of cardiovascular and allcause mortality in chronic hemodialysis patients [5,6,7,8,9] and is detected for more than 50% predialysis patients and for 80–90% patients with ESRD [10,11]
Sekikawa et al have observed that the association of aortic calcification with stiffness begins as early as the 40s in healthy individuals [16], another study has proved progression of coronary artery calcification in ESRD patients undergoing dialysis at the 30s [17]
Summary
Kidney transplantation (KT) is the most effective treatment method for patients with end-stage renal disease (ESRD) that increases life expectancy [1], but these patients suffer from higher cardiovascular mortality than the general population [2,3]. More than half of ESRD patient deaths are caused by cardiovascular diseases [4]. Interrelationship between aortic calcification and aortic stiffness [13,14], a hallmark of vascular aging [15], have been shown in ESRD patients. Sekikawa et al have observed that the association of aortic calcification with stiffness begins as early as the 40s in healthy individuals [16], another study has proved progression of coronary artery calcification in ESRD patients undergoing dialysis at the 30s [17]. There are few studies which have evaluated post-transplant PWV in the context of VC [22,23,24]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
