Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 16;13(20):6171.
doi: 10.3390/jcm13206171.

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

Iva Žuža  1 , Doris Dodig  2 , Ivan Brumini  1 , Mate Kutlić  3 , Robert Đurić  3 , Nataša Katalinić  3   4 , Antun Gršković  3   5 , Ante Jakšić  3   5 , Martina Mavrinac  6 , Tanja Ćelić  3 , Sanjin Rački  3   7 , Lidija Orlić  3   7 , Jasna Nekić  8 , Dean Markić  3   5
Affiliations

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

Iva Žuža et al. J Clin Med. .

Abstract

Background: 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. Methods: 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. Results: 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 (p = 0.006 and p = 0.008, respectively). MACE and renal function indicators 1-year post-transplant were similar across all PCS groups. Conclusions: 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.

Keywords: kidney transplant outcomes; kidney transplantation; spiral computed; tomography; vascular calcification.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Relationship between two observers (I.Ž. and I.B.) in the assessment of calcifications of iliac arteries (scatter diagram).
Figure 2
Figure 2
Kaplan–Meier survival curve of overall graft survival during the first post-transplant year (N = 79).
Figure 3
Figure 3
Kaplan–Meier survival curve of overall graft survival between three PCS groups during the first post-transplant year. (N = 79).
Figure 4
Figure 4
Kaplan–Meier survival curve of patient survival during the first post-transplant year (N = 79).
Figure 5
Figure 5
Kaplan–Meier survival curve of patient survival between three PCS groups during the first post-transplant year (N = 79).
See this image and copyright information in PMC

References

    1. Golledge J. Abdominal aortic calcification: Clinical significance, mechanisms and therapies. Curr. Pharm. Des. 2014;20:5834–5838. doi: 10.2174/1381612820666140212195309. - DOI - PubMed
    1. Lee S.J., Lee I.-K., Jeon J.-H. Vascular Calcification—New Insights into Its Mechanism. Int. J. Mol. Sci. 2020;21:2685. doi: 10.3390/ijms21082685. - DOI - PMC - PubMed
    1. Greenland P., Blaha M.J., Budoff M.J., Erbel R., Watson K.E. Coronary Calcium Score and Cardiovascular Risk. J. Am. Coll. Cardiol. 2018;72:434–447. doi: 10.1016/j.jacc.2018.05.027. - DOI - PMC - PubMed
    1. Alexopoulos D., Toulgaridis T., Davlouros P., Christodoulou J., Sitafidis G., Vagenakis A.G. Prognostic significance of coronary artery calcium in asymptomatic subjects with usual cardiovascular risk. Am. Heart J. 2003;145:542–548. doi: 10.1067/mhj.2003.169. - DOI - PubMed
    1. Fornasari A., Kuntz S., Martini C., Perini P., Cabrini E., Freyrie A., Lejay A., Chakfé N. Objective Methods to Assess Aorto-Iliac Calcifications: A Systematic Review. Diagnostics. 2024;14:1053. doi: 10.3390/diagnostics14101053. - DOI - PMC - PubMed

LinkOut - more resources