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Serum Calcification Propensity Is a Strong and Independent Determinant of Cardiac and All-Cause Mortality in Kidney

D O Dahle1,2, A Åsberg1,3,4, A Hartmann1,2

  • 1Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|September 17, 2015
PubMed

Insights

Calcification propensity, measured by T50, is linked to higher mortality in kidney transplant recipients. This blood test may offer new insights into cardiovascular risks post-transplant.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Biochemistry

Background:

  • Vascular calcification is a significant risk factor for cardiovascular disease and mortality in kidney transplant recipients.
  • A novel blood test, measuring calcification propensity via calciprotein particle transformation time (T50), offers a new metric for assessing this risk.

Purpose of the Study:

  • To investigate the association between calcification propensity (T50) and mortality in kidney transplant recipients.
  • To explore the relationship between T50 and aortic pulse wave velocity (APWV) in this patient cohort.

Main Methods:

  • T50 was measured in 1435 kidney transplant recipients across two eras (2000-2003 and 2009-2012).
  • APWV was assessed in 589 patients from the second era at baseline and 1-year follow-up.
  • Cox regression models were used to analyze the association between T50 and mortality over a median follow-up of 5.1 years.

Main Results:

  • Accelerated T50 was associated with factors including diabetes, deceased donor, first transplant, rejection, and higher serum phosphate.
  • T50 was not significantly associated with the progression of APWV.
  • Accelerated T50 was independently associated with increased all-cause mortality (HR 1.60) and cardiac mortality (HR 3.60).

Conclusions:

  • Calcification propensity, as measured by T50, is a strong independent predictor of both all-cause and cardiac mortality in kidney transplant recipients.
  • The findings suggest a potential cardiac pathway independent of APWV, highlighting T50 as a critical biomarker.
  • Further randomized trials are needed to determine if therapeutic interventions targeting T50 can improve patient outcomes.

Keywords:
cardiovascular diseaseclinical research / practicecomplication: medical / metabolicepidemiologykidney (allograft) function / dysfunctionkidney transplantation / nephrologypancreas / simultaneous pancreaskidney transplantation

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