Vascular calcification in long-term kidney transplantation

• Main Authors: Kotcharat Vipattawat, Chagriya Kitiyakara, Bunyong Phakdeekitcharoen, Surasak Kantachuvesiri, Vasant Sumethkul, Sophon Jirasiritham, Wasana Stitchantrakul, Sinee Disthabanchong
• Other Authors: Mahidol University
• Format: Article
• Published: 2018
• Subjects: Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/34495

Aim Vascular calcification (VC) is common among patients with chronic kidney disease (CKD) due to the strong prevalence of cardiovascular and CKD-related risk factors such as diabetes mellitus (DM), hypertension and phosphate retention. Kidney transplantation improves kidney function and abnormal mineral metabolism at the same time. It remains unclear whether kidney transplantation favourably impacts VC in the long-term. Methods The present study examined VC in 132 kidney transplant (KT) recipients who had been transplanted for longer than one year. The severity of VC was compared to 129 CKD stages 5-5D patients on a kidney transplant (KT) waiting list. Results The median KT vintage was 88 months. The prevalence of VC among KT and CKD patients were 54.5% and 62.8%, respectively, (P=0.2). There were no differences in age, gender, body mass index (BMI), the prevalence of DM or CVD between the two groups. Among patients with calcification, a more severe degree was observed in KT recipients (P=0.01). Aging, DM, CVD and dialysis vintage were associated with significant VC in both groups. The degree of VC in KT recipients was more pronounced than that in CKD patients among those who experienced prolonged dialysis vintage (>2 years) (P=0.04). Among KT recipients, the severity of VC increased with the length of time after transplantation and became more substantial after 5 years. Conclusions Long-term KT recipients demonstrated a more severe degree of VC compared to matched CKD stages 5-5D patients. The severity of VC became more pronounced among those with longer transplant vintage and was in part influenced by past dialysis experience. Summary at a Glance This study assesses vascular calcification (VC) in kidney transplant recipients and matched patients on dialysis. Not surprisingly, prevalence and determinants of VC were similar for both groups. Of interest, VC severity was greater in transplant patients than in patients on dialysis. Longitudinal studies are required to confirm these data. © 2014 Asian Pacific Society of Nephrology.