Abstract: TH-PO1004

Renal Parenchymal Calcifications in a Cohort of Renal Transplanted Patients and Their Correlations with Long Term Graft Outcome

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Alfieri, Carlo M., Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Ikehata, Masami, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Meneghini, Maria, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Messa, Piergiorgio, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Moroni, Gabriella, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Cresseri, Donata, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Regalia, Anna, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Zanoni, Francesca, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Binda, Valentina, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Gandolfo, Maria Teresa, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Campise, Mariarosaria, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
  • Simonini, Paola, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milan, Milan, Italy
Background

Renal calcifications(RC) have been described in kidney transplantation(KTx), but the aetiology and significance of this finding are still unclear. Our aim is to evaluate the prevalence an the clinical impact on long term graft prognosis of RC.

Methods

95 KTx pts,submitted to renal biopsy(RBx) on clinical indication from 2009 to 2012 were followed up until 2016 (FU time:(5[4-6]yrs).Clinical and biochemical data were collected at the time of RBx(TBX),12mth before(T-12) and after(T+12) the RBx. Exposition to Ca,P and PTH during the year before RBx was calculated by averages of the observed values.In yrs after T+12(Tfu),creatinine,Ca,P,PTH,ALP,Prot-U were recorded annually and analyzed as averages of observed values.
RBx were studied for general histology and for RC by Von Kossa(VK) staining. In pts with more than one RBx, only the 1st one was considered. Pts in which VK was negative or slight positive were defined as group1(VK-1:n 68;46 slightly positive), while pts with moderate or severe VK positivity were included in group2(VK-2:n=27;8 high VK positive).

Results

The pts were 51 males and 44 females,age 50±12 yrs. VK groups did not differ for gender,age, type of KTx, VK-2 had longer time of KTx(p= 0.03). At T-12,TBX and T+12, renal function was similar between the groups. No differences were found in mineral metabolism(MM) at TBX,while VK-2 had a lower exposition to PTH during the year before RBx(p<0.001).
VK-2 had higher glomerulosclerosis(GS;p=0.04). During Tfu,VK-2 pts had worst sCr(p=0.04) higher PTH and ALP(p=0.03;p=0.002).
33 pts have lost their graft during the F-U time, with a higher prevalence in VK-2(p=0.0006). By means of Cox regression and Kaplan Meier analysis belonging to VK-2 was the stronger independent parameter related to graft loss (HR=3.49–p=0.001;K-M p<0.0001).

Conclusion

The prevalence of RC in RBx is quite high. RC correlated with PTH exposition during the year before RBx,but not with Ca and P levels.Time of KTx and GS also were related to RC,assigning to RC a significance of chronic damage rather than a simply result of MM imbalance, at least in the RBX performed on clinical indication. A relation between VK positivity at TBX and long term graft loss was also found.