Progression of Coronary Artery Calcification in Living Kidney Donors: A Follow-Up Study

Abstract

Background: Data on the long-term mortality and morbidity of living kidney donors are scarce. In the general population, coronary artery calcification (CAC) and progression of CAC are predictors of future cardiac risk. We conducted a study to determine the progression of CAC in renal transplant donors. Methods: We used multidetector computed tomography to examine CAC in 75 former renal transplant donors. A baseline and a follow-up scan were performed and changes in CAC scores were evaluated in each subject individually to calculate the incidence of CAC progression. Results: Baseline CAC prevalence was 16% and the mean CAC score was 5.3 ± 25.8. At the follow-up scan that was performed after an average of 4.8 ± 0.3 years, CAC prevalence increased to 72% and the mean CAC score to 12.5 ± 23.4. Progression of the individual CAC score was found between 18.7 and 26.7%, depending on the method used to define progression. In patients with baseline CAC, the mean annualized rate of CAC progression was 2.1. Presence of hypertension, high systolic blood pressure and an increase in BMI were the determinants of CAC progression. Conclusions: The rate of CAC progression does not seem to be high in carefully selected donors.

Living kidney donation does not adversely affect serum calcification propensity and markers of vascular stiffness

“…Altogether, our results indicate that a loss of GFR related to a reduction in nephron mass in the absence of kidney disease does not per se increase at 1 year the calcification risk. These data are in line with recent observations demonstrating that coronary calcium imaging scores are not enhanced and do not progress rapidly in LKDs [33,34] and confirm the observation that uninephrectomy in donors is not equivalent to CKD despite the reduction in GFR and kidney mass [35].…”

Maintenance of Ideal Cardiovascular Health and Coronary Artery Calcium Progression in Low-Risk Men and Women in the Framingham Heart Study

“…25 A significantly lower frequency for maintaining zero CAC (33%) was reported by Alagoz et al in 75 kidney donors. 26 In the current study in a community-based population, we observed that 80% of participants maintained a zero Agatston score (901/1119), not markedly different from prior findings in disease-based studies. Results of our study are consistent with other studies that describe variations in CVD and related health well-being varies within an otherwise low-risk middle-aged population free of CAC.…”

Serum biomarkers for arterial calcification in humans: A systematic review

“…Thirty-four articles published results investigating a possible association between calcium and arterial calcification ( Alagoz et al, 2014 ; Arad et al, 1998 ; Billington et al, 2020 ; Chen et al, 2006 ; Criqui et al, 2010 ; Foley et al, 2009 ; Grønhøj et al, 2016 ; Kim et al, 2013 ; Kwak et al, 2014 ; Liang et al, 2021 ; Nam et al, 2017 ; Nielsen et al, 2021 ; Park et al, 2011 ; Park et al, 2016 ; Shin et al, 2012 ; Tuersun et al, 2020 ; Tuttle and Short, 2009 ; Wei et al, 2020 ; Wu et al, 2016b ; Zagura et al, 2011 ; Barbarash et al, 2016 ; Cancela et al, 2012 ; Chai et al, 2017 ; Davaine et al, 2016 ; Diederichsen et al, 2017 ; Donate-Correa et al, 2019 ; Golovkin et al, 2016 ; Liu et al, 2019 ; Masai et al, 2013 ; Pirro et al, 2013 ; Schlieper et al, 2010 ; Torii et al, 2016 ; Awan et al, 2010 ; Razavi et al, 2021 ). Of these studies, nine reported positive associations ( Grønhøj et al, 2016 ; Kwak et al, 2014 ; Nielsen et al, 2021 ; Shin et al, 2012 ; Tuttle and Short, 2009 ; Zagura et al, 2011 ; Diederichsen et al, 2017 ; Golovkin et al, 2016 ; Awan et al, 2010 ) and 25 reported no significant association ( Alagoz et al, 2014 ; Arad et al, 1998 ; Billington et al, 2020 ; Chen et al, 2006 ; Criqui et al, 2010 ; Foley et al, 2009 ; Kim et al, 2013 ; Liang et al, 2021 ...…”