Coronary artery calcification and coronary ischaemia in renal transplant recipients

Seyahi, Nurhan; Kahveci, Arzu; Cebi, Deniz; Altıparmak, Mehmet Rıza; Akman, Canan; Uslu, İlhami; Ataman, Rezzan; Taşçı, Hasan; Serdengeçtı, Kamıl

doi:10.1093/ndt/gfq413

Cited by 20 publications

(21 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An association between CAC and dialysis vintage has already been demonstrated (Rosas et al 2005). Contrary to Seyahi et al (2011), we found no association between CAC and transplantation duration.…”

Section: Discussioncontrasting

confidence: 99%

“…As in most other studies examining dialysis (Kraśniak et al 2007) or Tx patients (Rosas et al 2005;Mazzaferro et al 2007;Seyahi et al 2011) CAC significantly correlated with age in both examined groups. In addition, patients from both subgroups with CAC had undergone significantly longer CKD and/or dialysis duration than patients without CAC.…”

Section: Discussionsupporting

confidence: 82%

“…Rosas et al (2005) found CAC in 65% of Tx recipients but 66% of the examined patients were diabetics. In other studies with significantly fewer diabetics a similar prevalence of CAC was found in Tx patients Seyahi et al 2011). In the large Dallas Heart Study among 2,660 participants aged 43.9 years, Kramer et al (2005) observed a 25% prevalence of a CAC score of >10 and 15% of CAC scores > 100 in 28 non-diabetic stage 3-5 CKD patients, but in 13 diabetics stage 3-5 CKD patients the prevalence of a CAC score >10 was 85%.…”

Section: Discussionsupporting

confidence: 75%

See 2 more Smart Citations

Risk Factors Associated with Coronary Artery Calcification Should Be Examined before Kidney Transplantation

Simić-Ogrizović¹,

Bogavac-Stanojević

Vuckovic

et al. 2012

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

The best treatment for end stage renal disease (ESRD) patients is kidney transplantation, but the renal transplant recipients still have a higher incidence of cardiovascular events compared with general population. Cardiovascular risk factors were imposed long before ESRD, as the majority of patients starting dialysis or kidney transplantation already have signs of advanced atherosclerosis. Artery calcification is an organized, regulated process similar to bone formation. Coronary artery calcification (CAC) is found frequently in advanced atherosclerotic lesions and could be a useful marker of them. We evaluated the prevalence of CAC in 49 stable renal transplant recipients and in 48 age-and gender-matched patients with chronic kidney disease (CKD) in stages 2-5 not requiring dialysis to assess risk factors associated with CAC. Computed tomography was used for CAC detection and quantification (CAC score). The prevalence of CAC was 43.8% in transplant recipients and 16.7% in CKD patients (p < 0.001). Transplant recipients with CAC were significantly older and had longer duration of CKD and/or dialysis than recipients without CAC. In contrast, the serum levels of fetuin A (an inhibitor of vascular calcification) and albumin were significantly lower in CKD patients with CAC than those without CAC. During the observation period (30 months), 30 patients, including 23 CKD patients, began dialysis, and 4 transplant recipients and 2 CKD patients died. Independent predictors of mortality were age, serum amyloid A and the CAC score. In conclusion, the examination and prevention of risk factors associated with atherosclerosis should be started at the beginning of renal failure.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 75%

See 1 more Smart Citation

Risk Factors Associated with Coronary Artery Calcification Should Be Examined before Kidney Transplantation

Simić-Ogrizović¹,

Bogavac-Stanojević

Vuckovic

et al. 2012

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

show abstract

“…All papers were observational studies: 11 were prospective, 10 analyzed the prevalence or progression of VC, and 3 studied the impact of VC and vascular outcomes. The prevalence of coronary artery calcification (CAC) in KTRs is higher (61-75%) than that assessed in stage 3 CKD [5,6,7] and lower than that found in hemodialysis patients [8], possibly due to a selection bias of KTRs upon admission to the waiting list. The determinants associated with its presence are: age, dialysis vintage, time on transplantation and high/low turnover bone disease [9].…”

Section: Cardiovascular Disease and Vascular Calcification In Kidney mentioning

confidence: 99%

“…CAC, detected and quantified by CT, affords a reliable linear anatomic estimate of the total plaque burden and is taken clinically as a ‘calcium score'. In the general population, the presence of CAC is associated with symptoms of coronary ischemia and there is a trend towards higher rates of coronary ischemia by scintigraphy in patients with severe CAC [5,58]. In these studies the prevalence of silent myocardial ischemia by scintigraphy was found to be between 10.4 and 46% in patients who had a CAC score >400.…”

Section: Cac Assessmentmentioning

confidence: 99%

Importance of Vascular Calcification in Kidney Transplant Recipients

Cianciolo¹,

Capelli²,

Angelini³

et al. 2014

Am J Nephrol

View full text Add to dashboard Cite

Background: Kidney transplantation is the treatment of choice for chronic kidney disease (CKD), but in kidney transplant recipients (KTRs) cardiovascular events are the first cause of death with a functioning graft, ranging from 36 to 55%. The impact of vascular calcification (VC) on morbidity and mortality of KTRs is not appreciated enough nowadays. Summary: This review summarizes 13 important studies on VC in KTRs, comparing the results with CKD and dialysis populations. We focused on VC evaluation and use of coronary artery calcification (CAC) and aorta calcification (AoC) scores. We also evaluated the influence of traditional and non-traditional progression risk factors. Key Messages: VC strongly predicts cardiovascular events and all-cause mortality in KTRs. VC assessment is important in KTRs and based essentially on multislice computed tomography or electron beam computed tomography recognition of lesions. Quantitative measurement of CAC and AoC scores is essential for a correct definition of the calcium burden before and after kidney transplant. Progression of CAC slows down but does not halt after kidney transplant. A variable association of both traditional and non-traditional risk factors is shown. There is a strong association between baseline CAC score and CAC progression. A significant improvement in secondary hyperparathyroidism after transplantation favorably affects the progression of CAC. Low 25(OH)D₃ levels are an independent determinant of CAC progression. Diabetes is a risk factor for the presence of CAC in KTRs, but has not been independently associated with CAC progression. The data published on the use of immunosuppressive drugs as progression factors are few and inconclusive.

show abstract

Bone mineral density of extremities is associated with coronary calcification and biopsy-verified vascular calcification in living-donor renal transplant recipients

et al. 2016

View full text Add to dashboard Cite

Chronic kidney disease (CKD) mineral and bone disorders (CKD-MBD) may lead to low bone mineral density (BMD) and vascular calcification (VC), but links to the latter are unclear. Here we investigated associations between BMD, coronary artery calcium (CAC) scores, and histological signs of VC in end-stage renal disease (ESRD) patients undergoing living-donor kidney transplantation (LD-Rtx). In 66 ESRD patients (median age 45 years, 68% males), BMD (by dual-energy X-ray absorptiometry, DXA), CAC score (by computed tomography, CT; n = 54), and degree of VC score (graded by histological examination of epigastric artery specimens collected at LD-Rtx; n = 55) were assessed at the time of LD-Rtx. Of the patients, 26% had osteopenia and 7% had osteoporosis. Of those undergoing artery biopsy, 16% had extensive VC, and of those undergoing CT 28% had high CAC score (>100 Agatston units). CAC scores correlated with BMD of legs and pelvis. BMDs of leg and pelvic sub-regions were significantly lower in patients with extensive VC. In multivariate regression analysis adjusted for age and gender, lower BMD of leg sub-region was associated with CAC score >100 AUs and extensive VC, and patients with extensive VC had significantly higher CAC score. Both high CAC and extensive VC were independently predicted by low BMD of legs. Low BMD has the potential to identify ESRD patients at risk of vascular calcification.

show abstract

Coronary artery calcification and coronary ischaemia in renal transplant recipients

Abstract: CAC is highly prevalent in renal transplant recipients; it is associated with symptoms of coronary ischaemia. Time on transplantation is an independent determinant of CAC. Future studies to evaluate the prognostic significance of CAC in these patients are necessary.

Cited by 20 publications

References 38 publications

Risk Factors Associated with Coronary Artery Calcification Should Be Examined before Kidney Transplantation

Risk Factors Associated with Coronary Artery Calcification Should Be Examined before Kidney Transplantation

Importance of Vascular Calcification in Kidney Transplant Recipients

Bone mineral density of extremities is associated with coronary calcification and biopsy-verified vascular calcification in living-donor renal transplant recipients

Contact Info

Product

Resources

About