Serum Calcification Propensity Is a Strong and Independent Determinant of Cardiac and All-Cause Mortality in Kidney Transplant Recipients

• DOI: 10.1111/ajt.13443
• Publication Date: 2015-09-16T20:28:35Z
• Authors: D.O. Dahle; A. Åsberg; A. Hartmann; H. Holdaas; M. Bachtler; T.G. Jenssen; M. Dionisi; A. Pasch
• Keywords: Adult; Graft Rejection; Male; Graft Survival; Calcinosis; Middle Aged; Pulse Wave Analysis; Kidney Function Tests; Prognosis; Kidney Transplantation; 3. Good health; 03 medical and health sciences; Calcification, Physiologic; Postoperative Complications; 0302 clinical medicine; Cardiovascular Diseases; Risk Factors; Humans; Kidney Failure, Chronic; Female; Aged; Follow-Up Studies; Glomerular Filtration Rate

Calcification of the vasculature is associated with cardiovascular disease and death in kidney transplant recipients. A novel functional blood test measures calcification propensity by quantifying transformation time (T50) from primary to secondary calciprotein particles. Accelerated T50 indicates a diminished ability serum resist calcification. We measured 1435 patients 10 weeks after transplantation during 2000–2003 (first era) 2009–2012 (second era). Aortic pulse wave velocity (APWV) was at week 1 year 589 second era. diabetes, deceased donor, first transplant, rejection, stronger immunosuppression, era, higher phosphate lower albumin. not progression APWV. During median follow-up 5.1 years, 283 died, 70 myocardial infarction, cardiac failure or sudden death. In Cox regression models, accelerated strongly independently both all-cause mortality, low versus high quartile: hazard ratio 1.60 (95% confidence interval [CI] 1.00–2.57), ptrend= 0.03, 3.60 CI 1.10–11.83), ptrend = 0.02, respectively. conclusion, mortality recipients, potentially via nonAPWV-related pathway. Whether therapeutic improvement improves outcome awaits clarification randomized trial.