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

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
DOI: 10.1111/ajt.13443 Publication Date: 2015-09-16T20:28:35Z
ABSTRACT
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.
SUPPLEMENTAL MATERIAL
Coming soon ....
REFERENCES (38)
CITATIONS (75)