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Aorto-Iliac Artery Calcification Prior to Kidney Transplantation

Benjamens, S., Rijkse, E., Te Velde-Keyzer, C. A., Berger, S. P., Moers, C., de Borst, M. H., Yakar, D., Slart, R. H. J. A., Dor, F. J. M. F., Minnee, R. C. & Pol, R. A., Sep-2020, In : Journal of Clinical Medicine. 9, 9, 13 p., 2893.

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As vascular calcification is common in kidney transplant candidates, aorto-iliac vessel imaging is performed for surgical planning. The aim of the present study was to investigate whether a novel non-contrast enhanced computed tomography-based quantification technique for aorto-iliac calcification can be used for cardiovascular risk stratification prior to kidney transplantation. In this dual-center cohort study, we measured the aorto-iliac calcium score (CaScore) of 547 patients within three years prior to transplantation (2005-2018). During a median (interquartile range) follow-up of 3.1 (1.4, 5.2) years after transplantation, 80 (14.7%) patients died, of which 32 (40.0%) died due to cardiovascular causes, and 84 (15.5%) patients had a cardiovascular event. Kaplan-Meier survival curves showed significant differences between the CaScore tertiles for cumulative overall-survival (Log-rank testp<0.0001), cardiovascular survival (p<0.0001), and cardiovascular event-free survival (p<0.001). In multivariable Cox regression, the aorto-iliac CaScore was associated with all-cause mortality (hazard ratio 1.53, 95%CI 1.14-2.06,p= 0.005), cardiovascular mortality (2.04, 1.20-3.45,p= 0.008), and cardiovascular events (1.35, 1.01-1.80,p= 0.042). These independent associations of the aorto-iliac CaScore with the outcome measures can improve the identification of patients at risk for (cardiovascular) death and those who could potentially benefit from stringent cardiovascular monitoring to improve their prognosis after transplantation.

Original languageEnglish
Article number2893
Number of pages13
JournalJournal of Clinical Medicine
Volume9
Issue number9
Publication statusPublished - Sep-2020

    Keywords

  • kidney transplantation, vascular calcification, aorta, iliac artery, cardiovascular diseases, CARDIOVASCULAR EVENTS, AORTIC CALCIFICATION, COMPUTED-TOMOGRAPHY, SCORE, QUANTIFICATION, INFLAMMATION, PROGRESSION, CANDIDATES, SURVIVAL

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