Tambi Jarmi1, Aaron C Spaulding2, Abdullah Jebrini3, David M Sella4, Lauren F Alexander4, Samuel Nussbaum5, Mira Shoukry5, Launia White6, Hani M Wadei3, Houssam Farres5. 1. Department of Transplant, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL, 32224, USA. Jarmi.Tambi@mayo.edu. 2. Division of Health Delivery Research, Mayo Clinic Florida, Jacksonville, USA. 3. Department of Transplant, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL, 32224, USA. 4. Department of Radiology, Mayo Clinic Florida, Jacksonville, USA. 5. Division of Vascular Surgery, Mayo Clinic Florida, Jacksonville, USA. 6. Department of Quantitative Health Sciences, Mayo Clinic Florida, Jacksonville, USA.
Abstract
BACKGROUND: Abdominal arterial calcification (AAC) is common among candidates for kidney transplant. The aim of this study is to correlate AAC score value with post-kidney transplant outcomes. METHODS: We modified the coronary calcium score by changing the intake data points and used it to quantitate the AAC. We conducted a retrospective clinical study of all adult patients who were transplanted at our center, between 2010 and 2013, and had abdominal computed tomography scan done before transplantation. Outcomes included mortality, pulse pressure (PP) measured by 24 h ambulatory blood pressure monitoring system, and kidney allograft function measured by iothalamate clearance. RESULTS: For each 1000 increase of AAC score value, there is an associated 1.05 increase in the risk of death (95% CI 1.02, 1.08) (p < 0.001). Overall median AAC value for all patients was 1784; Kaplan-Meier curve showed reduced survival of all-cause mortality for patients with AAC score value above median and reduced survival among patients with cardiac related mortality. The iothalamate clearance was lower among patients with total AAC score value above the median. Patients with abnormal PP (< 40 or > 60 mmHg) had an elevated median AAC score value at 4319.3 (IQR 1210.4, 11097.1) compared to patients with normal PP with AAC score value at 595.9 (IQR 9.9, 2959.9) (p < 0.001). CONCLUSION: We showed an association of AAC with patients' survival and kidney allograft function after kidney transplant. The AAC score value could be used as a risk stratification when patients are considered for kidney transplant.
BACKGROUND: Abdominal arterial calcification (AAC) is common among candidates for kidney transplant. The aim of this study is to correlate AAC score value with post-kidney transplant outcomes. METHODS: We modified the coronary calcium score by changing the intake data points and used it to quantitate the AAC. We conducted a retrospective clinical study of all adult patients who were transplanted at our center, between 2010 and 2013, and had abdominal computed tomography scan done before transplantation. Outcomes included mortality, pulse pressure (PP) measured by 24 h ambulatory blood pressure monitoring system, and kidney allograft function measured by iothalamate clearance. RESULTS: For each 1000 increase of AAC score value, there is an associated 1.05 increase in the risk of death (95% CI 1.02, 1.08) (p < 0.001). Overall median AAC value for all patients was 1784; Kaplan-Meier curve showed reduced survival of all-cause mortality for patients with AAC score value above median and reduced survival among patients with cardiac related mortality. The iothalamate clearance was lower among patients with total AAC score value above the median. Patients with abnormal PP (< 40 or > 60 mmHg) had an elevated median AAC score value at 4319.3 (IQR 1210.4, 11097.1) compared to patients with normal PP with AAC score value at 595.9 (IQR 9.9, 2959.9) (p < 0.001). CONCLUSION: We showed an association of AAC with patients' survival and kidney allograft function after kidney transplant. The AAC score value could be used as a risk stratification when patients are considered for kidney transplant.
Authors: Giuseppe Cianciolo; Irene Capelli; Maria Laura Angelini; Chiara Valentini; Olga Baraldi; Maria P Scolari; Sergio Stefoni Journal: Am J Nephrol Date: 2014-05-07 Impact factor: 3.754
Authors: Diana A Wu; Matthew L Robb; John L R Forsythe; Clare Bradley; John Cairns; Heather Draper; Christopher Dudley; Rachel J Johnson; Wendy Metcalfe; Rommel Ravanan; Paul Roderick; Charles R V Tomson; Christopher J E Watson; J Andrew Bradley; Gabriel C Oniscu Journal: Transplantation Date: 2020-06 Impact factor: 4.939
Authors: Elsaline Rijkse; Jacob L van Dam; Joke I Roodnat; Hendrikus J A N Kimenai; Jan N M IJzermans; Robert C Minnee Journal: Transpl Int Date: 2020-03-04 Impact factor: 3.842