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Abstract: PO0389

Vascular Calcifications in Renal Transplantation

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Ferreira, Ana Carina, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Mendes, Marco, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Silva, Cecilia, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Cotovio, Patrícia, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Aires, Ines, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Navarro, David, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Pereira, Fernando Caeiro, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Salvador, Rute Maria Silva, Nova Medical School, Lisbon, Lisboa, Portugal
  • Correia, Bruna F., Nova Medical School, Lisbon, Lisboa, Portugal
  • Cabral, M. Guadalupe, Nova Medical School, Lisbon, Lisboa, Portugal
  • Nolasco, Fernando E B, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Ferreira, Manuel A., Hospital Curry Cabral, Lisboa, Lisboa, Portugal
Background

The aim of this study was to analyse the progression of vascular calcifications (VC) in a cohort of renal transplanted patients.

Methods

Prospective cohort study of de novo renal transplant patients. All patients were submitted to X-ray of the pelvis and hands (Adragão score); bone biopsy; laboratorial and echocardiographic evaluation at baseline and after 12 months (time 0 and 1). At the end of the study, bone densitometry and non-contrast cardiac CT (Agatston score) were performed. Associations between variables were performed using Wilcoxon rank sum test and Spearman correlation test. STATA software was used and p < 0.05 was considered statistically significant.

Results

We recruited 85 patients during 29 months and 69 were included in the study (6 patients refuse to perform the 2nd evaluation, 5 had primary non-function of the kidney graft, 1 had no sample on bone biopsy in time 0 and 4 patients died). Mean age 50.1±12.7 years, 59 men (69.4%), 66 caucasian (77.6%), median BMI 25.1±3.4.
The median baseline and 12 months Adragão score had no differences. The median coronary artery calcium score (CACS) was 48.5 (0 – 535) and median percentile was 80 (0 – 92.5). Valvular calcifications were present in 15 and 16 patients at baseline and after 1 year (p>0.05).
CACS were correlated with age (p<0.001), both Adragão score (p<0.001), presence of valvular calcification in time 1 (p=0.004), baseline calcium (p=0.02), baseline and 1-year sclerostin (p=0.01; p=0.04). CACS were higher in patients with highest values of FGF23 at baseline (p=0.04). Using a pairwise correlation, vitamin D levels (r=0.4, p=0.0004), iPTH (r=0.6, p<0.001) and total cholesterol levels (r=-0.3, p=0.01) were correlated with the score. Coronary calcium percentile was correlated with Adragão score in the two time points (p=0.0001; p=0.002), with presence of valvular calcifications in time 1 evaluation (p=0.02), baseline and 1-year calcium levels (p=0.004; p=0.02) and baseline sclerostin (p=0.01).

Conclusion

VC stabilize after renal transplantation. Adragão score can assess VC in renal transplanted patients. Calcium and sclerostin correlated with Agatston scores.