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Kidney Week

Abstract: TH-PO221

Progression of Abdominal Aortic Calcification in Kidney Transplantation Recipients and Hemodialysis Patients

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Kono, Keiji, Kobe University Graduate School of Medicine, Kobe, Japan
  • Fujii, Hideki, Kobe University Graduate School of Medicine, Kobe, Japan
  • Yamada, Nozomi, Kobe University, Kobe, Japan
  • Watanabe, Kentaro, Kobe University Graduate School of Medicine, Kobe, Japan
  • Watanabe, Shuhei, Kobe University Graduate School of Medicine, Kobe, Japan
  • Goto, Kimihiko, Kobe University Graduate School of Medicine, Kobe, Japan
  • Goto, Shunsuke, Kobe University Graduate School of Medicne, Kobe, Japan
  • Nishi, Shinichi, Kobe University Graduate School of Medicine, Kobe, Japan
Background

Vascular calcification is a critical complication of chronic kidney disease (CKD), and its mechanism is multifactorial. It has been reported that kidney transplantation (KT) may slow down the progression of vascular calcification along with the improvement of kidney function. However, there is a paucity of data about the comparison of the progression of vascular calcification between KT and hemodialysis (HD) patients. The aim of the present study is to compare the progression of abdominal aortic calcification between KT recipients and incident HD patients.

Methods

Ninety-one patients who underwent KT from January 2008 to January 2016 and 56 patients who initiated hemodialysis from December 2012 to June 2014 in our institutes were included in this study. We assessed the abdominal aortic calcification index (ACI) using a non-contrast computed tomography. The timing of assessment of the baseline and follow-up ACI was as follows; KT group: at the time of KT and at 1∼2 years after KT , incident HD group: at the time of HD initiaion and at 1 year after HD initiation, respectively. The progression of ACI (△ACI (%/year)) was calculated and compared between KT recipients and incident HD patients.

Results

The KT group included 17 pre-emptive KT (PKT) recipients (Living donor; n= 17, Deceased donor; n= 0) and 74 non-PKT recipients (Living donor; n= 69, Deceased donor; n= 5). The dialysis vintage was 51.2±55.6 months in the KT group. The KT group had significantly lower △ACI compared to the incident HD group. Even after excluding the patients with pre ACI=0 (KT; n=34, incident HD; n=4), its relationship remained significant among the two groups. The baseline characteristics showed that the incident HD group had significantly higher prevalence of diabetes mellitus (DM) and higher age and body mass index (BMI) compared to the KT group. After adjustment for these traditional risk factors for vascular calcification using a propensity score matching, baseline ACI was comparable among the two groups, but the KT group had significantly lower △ACI compared to the incident HD group.

Conclusion

Our findings suggest that KT slows the progression of ACI compared to HD initiation.