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Abstract: PO2558

Predictors and Impact of Nephrocalcinosis in Renal Transplant Population: A Monocenter Retrospective Study

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Beaulieu, Jessie, CHU de Québec-Université Laval, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Thérien, Léa, CHU de Québec-Université Laval, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Riopel, Julie, CHU de Québec-Université Laval, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Latulippe, Eva, CHU de Québec-Université Laval, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Simonyan, David, Centre de recherche du CHUQ, Quebec, Quebec, Canada
  • Houde, Isabelle, CHU de Québec-Université Laval, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Agharazii, Mohsen, CHU de Québec-Université Laval, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Mac-Way, Fabrice, CHU de Québec-Université Laval, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
Background

Persistence of bone and mineral anomalies in post-transplant population has been suggested as contributing factors to nephrocalcinosis (NC) that could lead to graft dysfunction. However, adequate characterization of calcium deposits in biopsies from renal transplant patients are lacking. We thus aimed to determine: 1) the prevalence of NC in renal transplant patients, 2) the factors associated with NC and 3) the impact of NC on renal graft function.

Methods

This is a monocenter retrospective study using a protocolized renal biopsy from CHU de Québec, l’Hôtel-Dieu de Québec hospital from 2016-2018. All renal biopsies performed in 2016 at renal transplantation, at 6 and 24 months post-transplant were qualitatively and quantitatively analyzed for NC. Demographic, comorbidities and biochemistry parameters were collected from patients’ records. Appropriate statistical analyses (Pearson’s chi-squared, Wilcoxon-Mann-Whitney, Spearman’s correlation and logistic regression) were performed to assess factors associated with NC and its impact on graft function.

Results

We included 53 patients (mean age of 52±13 years, 55% of men, 94% with hypertension, 23% with peripheral arterial disease and 19% with prior parathyroidectomy). Forty-nine patients (92%) were on chronic dialysis treatment before transplant for a mean duration of 34±29 months. The presence of NC was observed in 14% at baseline, 37% at 6 months and 50% at 24 months. The severity of NC as assessed by the number of calcified foci in the tubulointerstitial compartment also tended to increase over time. Analyses showed that the presence of NC at 6 months was associated with male sex, presence of NC at baseline and high PTH levels (> 600 ng/L) at the time of transplant. Presence of NC at 24 months was also associated with prior NC and male sex. Interestingly, the presence of NC at 6 months was associated with use of phosphate supplements immediately after engraftment and with active vitamin D treatment at 6 months. Finally, NC at 24 months was correlated with the level of graft function as expected.

Conclusion

This study reveals that uncontrolled mineral and bone metabolism parameters before renal transplant are associated with development of NC in the post-transplant period that may contribute to deterioration of renal graft function.