Ipsilateral Aorto-Iliac Calcification is Not Directly Associated With eGFR After Kidney Transplantation: A...

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Transplantation

Background:

• Aorto-iliac calcification (AIC) is a known risk factor for cardiovascular events and mortality post-transplant.
• The impact of AIC on kidney graft function, specifically estimated glomerular filtration rate (eGFR), is not well understood.

Purpose of the Study:

• To prospectively assess the association between AIC and eGFR in the first year following kidney transplantation.
• To investigate whether AIC influences the trajectory of graft function over time.

Main Methods:

• A prospective cohort study included 140 patients aged ≥50 years or ≥30 years with vascular disease risk factors.
• Aorto-iliac calcification (AIC) was quantified using a modified Agatston score from non-contrast-enhanced CT scans.
• The association between AIC and eGFR was analyzed using a linear mixed model, with adjustments for predefined variables.

Main Results:

• No direct association was found between the severity of AIC and eGFR levels in the first year post-transplant.
• A significant interaction between follow-up time and ipsilateral AIC was observed (p = 0.014).
• Patients with higher AIC scores exhibited a lower eGFR trajectory starting around 100 days post-transplant.

Conclusions:

• Severe aorto-iliac calcification (AIC) is not directly associated with lower post-transplant estimated glomerular filtration rate (eGFR).
• AIC demonstrates a significant interaction with time, indicating a declining eGFR trajectory in patients with more severe calcification after the initial 100 days post-transplant.
• This suggests a potential long-term impact of AIC on kidney graft function beyond the immediate post-transplant period.