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Quantitative Abdominal Arterial Calcification Correlates with Kidney Transplant Waitlist Mortality

Tambi Jarmi1, Tareq Hanouneh2, Michael Mao3

  • 1Department of Transplant, Mayo Clinic Florida, Jacksonville, Florida, USA.

Kidney & Blood Pressure Research
|May 23, 2024
PubMed

Insights

The abdominal arterial calcification (AAC) score is a valuable predictor of mortality risk for patients awaiting kidney transplants. Higher AAC scores correlate with an increased risk of death on the transplant waitlist.

Area of Science:

  • Cardiovascular Imaging
  • Transplant Surgery
  • Nephrology

Background:

  • Kidney transplantation faces organ scarcity, leading to long wait times for end-stage kidney disease patients.
  • Prolonged waitlists increase cardiovascular mortality risk, a significant concern for transplant candidates.
  • Large artery calcification is prevalent in kidney transplant candidates and is a known cardiovascular disease risk factor.

Purpose of the Study:

  • To assess the correlation between abdominal arterial calcification (AAC) score and mortality risk in patients on the kidney transplant waitlist.

Main Methods:

  • A modified coronary calcium scoring method was adapted to quantify AAC.
  • A retrospective study analyzed adult kidney transplant candidates listed between 2005 and 2015 with abdominal CT scans.
  • Patients were categorized into groups based on survival or mortality during the waitlist period.

Main Results:

  • An increase of 1,000 in the AAC score was significantly associated with a higher risk of death (HR 1.034, p=0.001).
  • This association persisted after adjusting for factors like age, diabetes, and dialysis status.
  • The AAC score effectively predicted mortality risk among kidney transplant waitlist patients.

Conclusions:

  • The AAC score shows promise as a noninvasive imaging biomarker for assessing mortality risk in kidney transplant candidates.
  • Integrating AAC scoring into routine imaging could enhance risk stratification and personalize patient care.
  • This tool may aid in better management of patients awaiting kidney transplants.
Abstract

Keywords:
Abdominal arterial calcificationEnd-stage kidney diseaseKidney transplantMortalityWaitlist

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