Abstract: FR-PO846
Do the Findings of Arterial Calcifications or Atherosclerosis on Pre-Transplant Cardiac Workup Correlate With Having Uncontrolled Hypertension Post Kidney Transplantation?
Session Information
- Transplantation: Clinical - Outcomes
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
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
- Alhamzah, Hamzah Ali, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- Alnazari, Nasser Mohammad, 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
- Tawhari, Mohammed Hadi, 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
- Iqbal, Dr Junaid, Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- Alhejaili, Fayez F., Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Background
ESKD is often associated with higher calcium scoring, calcification of the arteries or abnormal echocardiography findings. It is unknown if these anatomical changes contribute to uncontrolled hypertension (HTN) post KT.
Methods
A single center retrospective study of kidney transplant recipients (KTR) who underwent KT between January 2017 and May 2020 and followed up for 12 months.
The BP target was <140/90 mmHg as per published guidelines at the time of this study. We divided patients according to their blood pressure (BP) control at one-year post KT, into two groups: controlled (≤140/90) and uncontrolled (>140/90).
We collected data about patients’ demographics, baseline cardiovascular risk factors and their pretransplant imaging. Analyzed parameters included echocardiography (ejection fraction and wall motion abnormalities), nuclear stress test (calcium scoring, and cardiac perfusion), cardiac catheterization, and CT of pelvic arteries (assessing severity of calcifications/atherosclerosis).
Results
A total of 254 KTR were included. Of those, 74% were ≥ 30 years, 58% were men and 80% were living-donor kidney recipients. Preemptive transplantation was 10.1%, PD 11.5% and HD 78.4%, respectively. At one year, 76 (29.9%) of the patients did not attain the target BP goal of <140/90.
No pre-transplant cardiovascular imaging finding was associated with uncontrolled BP.
Age (47 vs. 41 years, P=0.008), and DM (P=0.012) were significantly correlated with higher incidence of uncontrolled HTN. However, gender, dialysis vintage, preemptive transplantation, type of dialysis, and type of transplant (living vs. deceased-donor KT) were not different among the two groups.
Multivariate analysis showed that an elevated creatinine (OR=1.016, CI=1.004-.028. p=0.01) and smoking (OR=3.58, CI=1.001-12.8. p=0.05) were significantly associated with uncontrolled BP.
Conclusion
Arterial calcification/ atherosclerosis on pre-KT cardiac work up did not correlate with uncontrolled hypertension at 12 months post KT.