In:
Kidney Diseases, S. Karger AG
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Coronary artery calcification score (CACS) and abdominal aortic calcification score (AACS) are both well-established markers of vascular stiffness, and previous studies have shown that a higher CACS is a risk factor for chronic kidney disease (CKD) progression. However, the impact of pretransplant CACS and AACS on cardiovascular and renal outcomes in kidney transplant patients has not been established. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We included 944 kidney transplant recipients from the KoreaN cohort study for Outcome in patients With Kidney Transplantation (KNOW-KT) cohort and categorized them into three groups (low, medium, and high) according to baseline CACS (0, 0 & lt; and ≤100, & gt;100) and AACS (0, 1–4, & gt;4). The low (0), medium (0 & lt; and ≤ 100), and high ( & gt;100) CACS groups each consisted of 462, 213, and 225 patients, respectively. Similarly, the low (0), medium (1–4), and high ( & gt;4) AACS groups included 638, 159, and 147 patients, respectively. The primary outcome was the occurrence of cardiovascular events. The secondary outcomes were all-cause mortality and composite kidney outcomes, which comprised of & gt;50% decline in the estimated glomerular filtration rate and graft loss. Cox regression analysis was used to investigate the association between baseline CACS/AACS and outcomes. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The high CACS group ( 〈 i 〉 N 〈 /i 〉 = 462) faced a significantly higher risk for cardiovascular outcomes (adjusted hazard ratio [aHR], 5.97; 95% confidence interval [CI] , 2.01–17.7) and all-cause mortality (aHR, 2.74; 95% CI, 1.27–5.92) compared to the low CACS group ( 〈 i 〉 N 〈 /i 〉 = 225). Similarly, the high AACS group ( 〈 i 〉 N 〈 /i 〉 = 638) had an elevated risk for cardiovascular outcomes (aHR, 2.38; 95% CI, 1.16–4.88). Furthermore, the addition of CACS to prediction models improved prediction indices for cardiovascular outcomes. However, the risk of renal outcomes did not differ among CACS or AACS groups. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Pretransplant arterial calcification, characterized by high CACS or AACS, is an independent risk factor for cardiovascular outcomes and mortality in kidney transplant patients.
Type of Medium:
Online Resource
ISSN:
2296-9381
,
2296-9357
Language:
English
Publisher:
S. Karger AG
Publication Date:
2024
detail.hit.zdb_id:
2817963-8
detail.hit.zdb_id:
2789480-0
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