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Updated: Apr 30, 2026

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Importance of vascular calcification in kidney transplant recipients
Giuseppe Cianciolo1, Irene Capelli, Maria Laura Angelini
1Nephrology, Dialysis and Transplantation Unit, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola University Hospital, Bologna, Italy.
Insights
Vascular calcification (VC) significantly predicts cardiovascular events and mortality in kidney transplant recipients (KTRs). Assessing VC using coronary artery calcification (CAC) and aorta calcification (AoC) scores is crucial for KTRs.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Cardiovascular events are the leading cause of death in kidney transplant recipients (KTRs).
- Vascular calcification (VC) significantly impacts morbidity and mortality in KTRs, yet its role is often underestimated.
- Chronic kidney disease (CKD) patients face high cardiovascular risks, with transplantation being the primary treatment.
Purpose of the Study:
- To review studies on vascular calcification (VC) in KTRs.
- To compare VC findings in KTRs with CKD and dialysis populations.
- To evaluate VC assessment methods and risk factors for progression.
Main Methods:
- Review of 13 studies on VC in KTRs.
- Focus on coronary artery calcification (CAC) and aorta calcification (AoC) scoring.
- Analysis of traditional and non-traditional risk factors influencing VC progression.
Main Results:
- VC strongly predicts cardiovascular events and mortality in KTRs.
- CAC progression slows post-transplant but continues.
- Low 25(OH)D3 levels and diabetes are associated with CAC progression, while improved secondary hyperparathyroidism is protective.
Conclusions:
- VC assessment using CAC and AoC scores is vital for KTRs.
- Quantitative measurement of calcium burden is essential before and after kidney transplant.
- Risk factor management is key to mitigating VC progression and cardiovascular events in KTRs.
Background:
Kidney transplantation is the treatment of choice for chronic kidney disease (CKD), but in kidney transplant recipients (KTRs) cardiovascular events are the first cause of death with a functioning graft, ranging from 36 to 55%. The impact of vascular calcification (VC) on morbidity and mortality of KTRs is not appreciated enough nowadays.
Summary:
This review summarizes 13 important studies on VC in KTRs, comparing the results with CKD and dialysis populations. We focused on VC evaluation and use of coronary artery calcification (CAC) and aorta calcification (AoC) scores. We also evaluated the influence of traditional and non-traditional progression risk factors.
Key Messages:
VC strongly predicts cardiovascular events and all-cause mortality in KTRs. VC assessment is important in KTRs and based essentially on multislice computed tomography or electron beam computed tomography recognition of lesions. Quantitative measurement of CAC and AoC scores is essential for a correct definition of the calcium burden before and after kidney transplant. Progression of CAC slows down but does not halt after kidney transplant. A variable association of both traditional and non-traditional risk factors is shown. There is a strong association between baseline CAC score and CAC progression. A significant improvement in secondary hyperparathyroidism after transplantation favorably affects the progression of CAC. Low 25(OH)D3 levels are an independent determinant of CAC progression. Diabetes is a risk factor for the presence of CAC in KTRs, but has not been independently associated with CAC progression. The data published on the use of immunosuppressive drugs as progression factors are few and inconclusive.
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