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Abstract: FR-PO845

Do the Findings of Arterial Calcifications or Atherosclerosis on Pre-Transplant Cardiovascular Imaging Correlate With Persistent Hyperparathyroidism at 1 Year Post Kidney Transplantation?

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Arabi, Ziad, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Abdulgadir, Mohamad Yousif, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Youssouf, Talha Mohammad, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Alkhudhairy, Aya Kamil, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Mahmoud, Osama Ahmed, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Elhassan, Elwaleed A., Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Alflaiw, Ahmad I., Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Alghamdi, Hazim Safar, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Alhamzah, Hamzah Ali, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  • Althani, Abdullah Saleh, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Background

Hyperparathyroidism is common in chronic kidney disease, and it can persist post kidney transplantation (KT). It is unknown whether the findings of arterial calcifications/ atheroscleosis on cardiovascular imaging pre- transplantation correlate with the persistence of hyperparathyroidism (persHPTH) at one-year post-renal transplantation.

Methods

A single center retrospective study of renal transplant candidates from January 2017 to May 2020. We collected patients’ demographics, cardiovascular (CV) risk factors, the findings of pre- transplant CV imaging (echo, nuclear cardiac perfusion stress test, calcium scoring, cardiac catheterization results and the degree of calcification/atherosclerosis of pelvic arteries on screening pelvic CT scan). We also collected iPTH values [at baseline (before transplant), 1- 6 months, 6-12 months, and 12-24 months post transplantation]. We defined persHPTH as iPTH ≥ 25.5 pmol/L after 12 months post kidney transplantation (normal= 12.73 pmol/L).

Results

A total of 287 kidney transplant recipients (KTR) were included. 74% were ≥ 30 years, 58% were men and 80% were living-donor KTR. Preemptive transplantation was performed in 10.1%. Dialysis modality used prior to KT was PD in 11.5% and HD in 78.4% (AVF: 42% versus Permcath: 58%). Dialysis vintage was 4.8±3.3 years for deceased donor kidney transplantation (DDKT) versus 2.4±2.6 years for living donor kidney transplantation (LKT). The prevalence of persHPTH was 16.4% (n=47)

There were no association between persHPTH and the findings of pre- transplant CV imaging including echo findings (EF, LVH and abnormal wall motion), cardiac nuclear perfusion stress test (cardiac PET), cardiac catheterization, calcification/atherosclerosis of pelvic arteries seen on screening pelvic CT scan. However, the presence of calcium scoring ≥ 400 on pre -transplant cardiac PET scan was associated with higher incidence of persHPTH at 12 months post renal transplantation (37% versus 13.1%; p: 0.013).

Conclusion

Higher calcium scoring (> 400) seen on cardiac PET scan during pre-translant workup is associated with higher incidence of persHPTH at 12 months post KT.