Abstract:
Background: Vascular calcification is as active process in dialysis patients, It remains unclear if calcification related to dialysis is ameliorated after renal transplantation or not. Multi-detector computed tomography remain as a gold standard for noninvasively determine the quantity of CAC. Our aim is to study the effect of renal transplantation on vascular calcification occurred among hemodialysis patients and the risk factors for development of vascular calcification and its progression after kidney transplantation.
Methods: Transplant registry in Mansoura Urology and Nephrology Center was reviewed for kidney transplant recipients with pre-transplant non-contrast spiral CT chest. So, 149 recipients were included and they were divided according to the presence of vascular calcification into 2 groups. Group I: 58 KTRs with pre-transplant vascular calcification, Group II: 91 KTRs without pre-transplant vascular calcification.
Results: Pre-transplant vascular calcification was predominant among old age, males with high pre-transplant intact PTH levels. After kidney transplantation, the number of patients with vascular calcification slightly increased but the severity of vascular calcification significantly increased. High pre-transplant calcium score, longer hemodialysis duration and high intact PTH levels are associated with post-transplant vascular calcification progression.
Conclusion: it is better to courage pre-emptive kidney transplantation or to decrease the incidence of post-transplant vascular calcification. Also, candidates for renal transplantation should keep PTH within accepted level to decrease the chance for vascular calcification.