Importance of Vascular Calcification Kidney Transplant Recipients

被引：54

作者：

Cianciolo, Giuseppe ^{[1
]}

Capelli, Irene ^{[1
]}

Angelini, Maria Laura ^{[1
]}

Valentini, Chiara ^{[1
]}

Baraldi, Olga ^{[1
]}

Scolari, Maria P. ^{[1
]}

Stefoni, Sergio ^{[1
]}

机构：

[1] S Orsola Univ Hosp, Dept Expt Diagnost & Specialty Med, Nephrol Dialysis & Transplantat Unit, IT-40138 Bologna, Italy

来源：

AMERICAN JOURNAL OF NEPHROLOGY | 2014年 / 39卷 / 05期

关键词：

Kidney transplant; Vascular calcification; CAC score; Calcification inhibitors; CORONARY-ARTERY CALCIFICATION; STAGE RENAL-DISEASE; ALL-CAUSE MORTALITY; GROWTH-FACTOR; 23; THORACIC AORTA CALCIFICATION; AMERICAN-HEART-ASSOCIATION; CARDIOVASCULAR EVENTS; COMPUTED-TOMOGRAPHY; RISK-FACTORS; MYCOPHENOLATE-MOFETIL;

D O I：

10.1159/000362492

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

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)D-3 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. (C) 2014 S. Karger AG, Basel

引用

页码：418 / 426

页数：9

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