Journal Mobile Options
Table of Contents
Vol. 27, No. 4, 2007
Issue release date: July 2007
Am J Nephrol 2007;27:329–335
(DOI:10.1159/000102978)

Prevalence and Determinants of Coronary and Aortic Calcifications Assessed by Chest CT in Renal Transplant Recipients

Nguyen P.T.H. · Coche E. · Goffin E. · Beguin C. · Vlassenbroek A. · Devuyst O. · Robert A. · Jadoul M.
aNephrology, bRadiology, cMedical Informatics, Cliniques universitaires St-Luc, dEpidemiology and Biostatistics, Ecole de santé publique, Université catholique de Louvain, and eClinical Science and Applications, Philips Medical Systems, Brussels, Belgium

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Background: Coronary artery calcifications independently predict cardiovascular events (CVE) in the general population. We assessed the prevalence and determinants of coronary (CAC) and thoracic aorta (AoC) calcifications in renal transplant recipients (RTR). Methods: Consecutive RTR living in Belgium, with an isolated kidney graft functioning for more than 1 year, were asked to participate. They underwent a 16-slice spiral computerized tomography in order to measure calcium mass. Demographic, clinical, biochemical and urinary parameters were recorded. Results: We included 281 patients. CAC and AoC were detected in 81 and 85%, with geometric means (SD) of 52.2 (4.9) and 99.3 (8.2) mg, respectively. By multiple linear regression, independent predictors of both types of calcifications included older age, longer time on dialysis, a history of CVE, of multiple transplantations and of smoking. Other determinants of CAC were male gender, current statin use and history of parathyroidectomy, and other determinants of AoC included higher pulse pressure, shorter time under mycophenolate mofetil and current use of anti-vitamin-K. Conclusion: The prevalence of both CAC and AoC is substantial in RTR. We delineate independent determinants either common to both CAC and AoC or specific to one, and known as classic or chronic kidney disease related risk factors.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Pletcher MJ, Tice JA, Pignone M, Browner WS: Using the coronary artery calcium score to predict coronary heart disease events: a systematic review and meta-analysis. Arch Intern Med 2004;164:1285–1292.
  2. Chertow GM, Raggi P, Chasan-Taber S, Bommer J, Holzer H, Burke SK: Determinants of progressive vascular calcification in haemodialysis patients. Nephrol Dial Transplant 2004;19:1489–1496.
  3. Goodman WG, Goldin J, Kuizon BD, Yoon C, Gales B, Sider D, Wang Y, Chung J, Emerick A, Greaser L, Elashoff RM, Salusky IB: Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 2000;342:1478–1483.
  4. Ishitani MB, Milliner DS, Kim DY, Bohorquez HE, Heimbach JK, Sheedy PF, Morgenstern BZ, Gloor JM, Murphy JG, McBane RD, Bielak LF, Peyser PA, Stegall MD: Early subclinical coronary artery calcification in young adults who were pediatric kidney transplant recipients. Am J Transplant 2005;5:1689–1693.
  5. Kimura K, Saika Y, Otani H, Fujii R, Mune M, Yukawa S: Factors associated with calcification of the abdominal aorta in hemodialysis patients. Kidney Int Suppl 1999;71:S238–S241.
  6. Merjanian R, Budoff M, Adler S, Berman N, Mehrotra R: Coronary artery, aortic wall, and valvular calcification in nondialyzed individuals with type 2 diabetes and renal disease. Kidney Int 2003;64:263–271.
  7. Moe SM, O’Neill KD, Fineberg N, Persohn S, Ahmed S, Garrett P, Meyer CA: Assessment of vascular calcification in ESRD patients using spiral CT. Nephrol Dial Transplant 2003;18:1152–1158.
  8. Nitta K, Akiba T, Suzuki K, Uchida K, Ogawa T, Majima K, Watanabe R, Aoki T, Nihei H: Assessment of coronary artery calcification in hemodialysis patients using multi-detector spiral CT scan. Hypertens Res 2004;27:527–533.
  9. Russo D, Palmiero G, De Blasio AP, Balletta MM, Andreucci VE: Coronary artery calcification in patients with CRF not undergoing dialysis. Am J Kidney Dis 2004;44:1024–1030.
  10. Stompor T, Pasowicz M, Sullowicz W, Dembinska-Kiec A, Janda K, Wojcik K, Tracz W, Zdzienicka A, Klimeczek P, Janusz-Grzybowska E: An association between coronary artery calcification score, lipid profile, and selected markers of chronic inflammation in ESRD patients treated with peritoneal dialysis. Am J Kidney Dis 2003;41:203–211.
  11. Moe SM, O’Neill KD, Reslerova M, Fineberg N, Persohn S, Meyer CA: Natural history of vascular calcification in dialysis and transplant patients. Nephrol Dial Transplant 2004;19:2387–2393.
  12. Oh J, Wunsch R, Turzer M, Bahner M, Raggi P, Querfeld U, Mehls O, Schaefer F: Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation 2002;106:100–105.
  13. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R: Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990;15:827–832.
  14. Hong C, Bae KT, Pilgram TK: Coronary artery calcium: accuracy and reproducibility of measurements with multi-detector row CT – Assessment of effects of different thresholds and quantification methods. Radiology 2003;227:795–801.
  15. Ulzheimer S, Kalender WA: Assessment of calcium scoring performance in cardiac computed tomography. Eur Radiol 2003;13:484–497.
  16. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289:2560–2572.
  17. Perico N, Gaspari F, Remuzzi G: Assessing renal function by GFR prediction equations in kidney transplantation. Am J Transplant 2005;5:1175–1176.
  18. Kasiske BL, Guijarro C, Massy ZA, Wiederkehr MR, Ma JZ: Cardiovascular disease after renal transplantation. J Am Soc Nephrol 1996;7:158–165.
  19. Raggi P, Callister TQ, Cooil B, He ZX, Lippolis NJ, Russo DJ, Zelinger A, Mahmarian JJ: Identification of patients at increased risk of first unheralded acute myocardial infarction by electron-beam computed tomography. Circulation 2000;101:850–855.
  20. McCullough PA, Sandberg KR, Dumler F, Yanez JE: Determinants of coronary vascular calcification in patients with chronic kidney disease and end-stage renal disease: a systematic review. J Nephrol 2004;17:205–215.
  21. Raggi P, Boulay A, Chasan-Taber S, Amin N, Dillon M, Burke SK, Chertow GM: Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease and cardiovascular disease? J Am Coll Cardiol 2002;39:695–701.
  22. Rosas SE, Mensah K, Weinstein RB, Bellamy SL, Rader DJ: Coronary artery calcification in renal transplant recipients. Am J Transplant 2005;5:1942–1947.
  23. Mielke CH Jr, Shields JP, Broemeling LD: Risk factors and coronary artery disease for asymptomatic women using electron beam computed tomography. J Cardiovasc Risk 2001;8:81–86.
  24. Mehrotra R, Budoff M, Hokanson JE, Ipp E, Takasu J, Adler S: Progression of coronary artery calcification in diabetics with and without chronic kidney disease. Kidney Int 2005;68:1258–1266.
  25. London GM, Marty C, Marchais SJ, Guerin AP, Metivier F, de Vernejoul MC: Arterial calcifications and bone histomorphometry in end-stage renal disease. J Am Soc Nephrol 2004;15:1943–1951.
  26. Shimizu H, Takahashi M, Takeda S, Inoue S, Fujishiro J, Hakamata Y, Kaneko T, Murakami T, Takeuchi K, Takeyoshi I, Morishita Y, Kobayashi E: Mycophenolate mofetil prevents transplant arteriosclerosis by direct inhibition of vascular smooth muscle cell proliferation. Transplantation 2004;77:1661– 1667.
  27. Romero F, Rodriguez-Iturbe B, Pons H, Parra G, Quiroz Y, Rincon J, Gonzalez L: Mycophenolate mofetil treatment reduces cholesterol-induced atherosclerosis in the rabbit. Atherosclerosis 2000;152:127–133.
  28. Asanuma Y, Oeser A, Shintani AK, Turner E, Olsen N, Fazio S, Linton MF, Raggi P, Stein CM: Premature coronary-artery atherosclerosis in systemic lupus erythematosus. N Engl J Med 2003;349:2407–2415.
  29. Schurgers LJ, Aebert H, Vermeer C, Bultmann B, Janzen J: Oral anticoagulant treatment: friend or foe in cardiovascular disease? Blood 2004;104:3231–3232.
  30. Koos R, Mahnken AH, Muhlenbruch G, Brandenburg V, Pflueger B, Wildberger JE, Kuhl HP: Relation of oral anticoagulation to cardiac valvular and coronary calcium assessed by multislice spiral computed tomography. Am J Cardiol 2005;96:747–749.
  31. Kramer H, Toto R, Peshock R, Cooper R, Victor R: Association between chronic kidney disease and coronary artery calcification: the Dallas Heart Study. J Am Soc Nephrol 2005;16:507–513.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50