Natural history of vascular calcification in dialysis and transplant patients

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Sharon M MoeCristopher A Meyer

Abstract

The purpose of the present study was to determine the natural history of coronary artery and aorta calcification by spiral computed tomography (CT) in patients who undergo a renal transplant and patients on haemodialysis. Two cohorts were evaluated for the natural history of vascular calcification: (i) 23 patients who underwent a baseline CT scan at the time of renal transplant and a repeat evaluation 15-20 months later; and (ii) 33 chronic kidney disease, stage 5 haemodialysis subjects who underwent a baseline CT scan, all followed for a minimum of 15 months, and 17 of whom underwent a second CT scan. In the patients undergoing a renal transplant, there was no net change in CAC with time, suggesting stabilization of calcification. In the haemodialysis patients, the median CAC increased by 1.27+/-1.88 score/days, P = 0.013. There was a trend towards increasing AoC score in both groups. All patients without calcification at baseline remained calcification free at follow-up. In the 15 months following baseline, the six dialysis patients who died had a significantly greater CAC score at baseline compared with the 24 patients who remained alive. Similarly, those patients who were hospitalized had a greater baseline CAC than patient...Continue Reading

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