Impact of Pelvic Calcification Severity on Renal Transplant Outcomes: A Prospective Single-Center Study

Vascular calcifications (VC) are increasingly prevalent in patients with chronic kidney disease. This study aimed to assess the incidence of iliac artery calcifications in kidney transplant (KT) patients and explore the relationship between iliac VC burden measured by pelvic calcification score (PCS...

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Bibliographic Details
Published in:	Journal of clinical medicine Vol. 13; no. 20; p. 6171
Main Authors:	Žuža, Iva, Dodig, Doris, Brumini, Ivan, Kutlić, Mate, Đurić, Robert, Katalinić, Nataša, Gršković, Antun, Jakšić, Ante, Mavrinac, Martina, Ćelić, Tanja, Rački, Sanjin, Orlić, Lidija, Nekić, Jasna, Markić, Dean
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 16-10-2024 MDPI
Subjects:	Abdomen Angina pectoris Body mass index Calcification Chi-square test Clinical outcomes Comorbidity Diabetes Evaluation Health aspects Heart attacks Hemodialysis Hospitalization Hospitals Hypertension Kidney diseases Kidney transplants Kidneys Medical imaging Morphology Patients Pelvis Peritoneal dialysis Renal replacement therapy Statistical analysis Survival analysis Transplantation Veins & arteries Croatia Germany spiral computed kidney transplant outcomes tomography kidney transplantation vascular calcification
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Summary:	Vascular calcifications (VC) are increasingly prevalent in patients with chronic kidney disease. This study aimed to assess the incidence of iliac artery calcifications in kidney transplant (KT) patients and explore the relationship between iliac VC burden measured by pelvic calcification score (PCS) and renal transplant outcomes. This prospective study involved 79 KT recipients. VC quantification, using a pre-transplant computed tomography (CT) scan, was performed by assessing calcifications in the common and external iliac arteries bilaterally, resulting in an overall PCS ranging from 0 (no calcifications) to 44 (extensive calcifications). Based on PCS values, patients were divided into three equal-sized groups: PCS Group 1 (PCS 0-4), PCS Group 2 (PCS 5-19), and PCS Group 3 (PCS > 19). Post-transplant outcomes tracked for at least 1 year were patient and graft survival, graft function (urea, creatinine, MAG-3 clearance), and incidence of MACE during the first post-transplant year. Calcifications were present in at least one arterial segment in 61 patients (77.2%). One-year patient survival was 95%, and one-year graft survival was 92.4%. Patients in PCS Group 3 had significantly lower one-year patient and graft survival compared to those in PCS Group 1 and 2 ( = 0.006 and = 0.008, respectively). MACE and renal function indicators 1-year post-transplant were similar across all PCS groups. Our study demonstrated that a significant majority of KT recipients exhibited iliac VC during pre-transplant CT assessments. Patients in PCS Group 3 exhibited significantly lower one-year patient and graft survival rates compared to those in PCS Groups 1 and 2, indicating that this subgroup may require more intensive post-transplant monitoring and management.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors contributed equally to this work.
ISSN:	2077-0383 2077-0383
DOI:	10.3390/jcm13206171