Skip to main content

Advertisement

SpringerLink
Log in

Association of Abdominal Arterial Calcification Score with Patients’ Survival and Kidney Allograft Function after Kidney Transplant

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Abdominal arterial calcification (AAC) is common among candidates for kidney transplant. The aim of this study is to correlate AAC score value with post-kidney transplant outcomes.

Methods

We modified the coronary calcium score by changing the intake data points and used it to quantitate the AAC. We conducted a retrospective clinical study of all adult patients who were transplanted at our center, between 2010 and 2013, and had abdominal computed tomography scan done before transplantation. Outcomes included mortality, pulse pressure (PP) measured by 24 h ambulatory blood pressure monitoring system, and kidney allograft function measured by iothalamate clearance.

Results

For each 1000 increase of AAC score value, there is an associated 1.05 increase in the risk of death (95% CI 1.02, 1.08) (p < 0.001). Overall median AAC value for all patients was 1784; Kaplan–Meier curve showed reduced survival of all-cause mortality for patients with AAC score value above median and reduced survival among patients with cardiac related mortality. The iothalamate clearance was lower among patients with total AAC score value above the median. Patients with abnormal PP (< 40 or > 60 mmHg) had an elevated median AAC score value at 4319.3 (IQR 1210.4, 11097.1) compared to patients with normal PP with AAC score value at 595.9 (IQR 9.9, 2959.9) (p < 0.001).

Conclusion

We showed an association of AAC with patients’ survival and kidney allograft function after kidney transplant. The AAC score value could be used as a risk stratification when patients are considered for kidney transplant.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Collins AJ et al (2012) United States renal data system 2011 annual data report: atlas of chronic kidney disease & end-stage renal disease in the United States. Am J Kidney Dis 59(1 Suppl 1):e1-420

    Google Scholar 

  2. Workgroup KD (2005) K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 45(4 Suppl 3):S1-153

    Google Scholar 

  3. Hariharan S, Israni AK, Danovitch G (2021) Long-term survival after kidney transplantation. N Engl J Med 385(8):729–743

    Article  CAS  PubMed  Google Scholar 

  4. Wu DA et al (2020) Recipient comorbidity and survival outcomes after kidney transplantation: a UK-wide prospective cohort study. Transplantation 104(6):1246–1255

    Article  PubMed  Google Scholar 

  5. Rijkse E et al (2020) The prognosis of kidney transplant recipients with aorto-iliac calcification: a systematic review and meta-analysis. Transpl Int 33(5):483–496

    Article  PubMed  Google Scholar 

  6. Cianciolo G et al (2014) Importance of vascular calcification in kidney transplant recipients. Am J Nephrol 39(5):418–426

    Article  CAS  PubMed  Google Scholar 

  7. Benjamens S et al (2020) Aorto-iliac artery calcification prior to kidney transplantation. J Clin Med 9(9):2893

    Article  CAS  PubMed Central  Google Scholar 

  8. Agatston AS et al (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832

    Article  CAS  PubMed  Google Scholar 

  9. Chirinos JA et al (2019) Large-artery stiffness in health and disease: JACC state-of-the-art review. J Am Coll Cardiol 74(9):1237–1263

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zhang Y et al (2020) Arterial stiffness in hypertension and function of large arteries. Am J Hypertens 33(4):291–296

    Article  PubMed  Google Scholar 

  11. Kruger B et al (2019) Pulse pressure and outcome in kidney transplantation: results from the collaborative transplant study. Transplantation 103(4):772–780

    Article  PubMed  Google Scholar 

  12. Safar ME (2008) Pulse pressure, arterial stiffness and wave reflections (augmentation index) as cardiovascular risk factors in hypertension. Ther Adv Cardiovasc Dis 2(1):13–24

    Article  PubMed  Google Scholar 

  13. Agarwal R (2003) Ambulatory GFR measurement with cold iothalamate in adults with chronic kidney disease. Am J Kidney Dis 41(4):752–759

    Article  PubMed  Google Scholar 

  14. So S et al (2021) Factors influencing long-term patient and allograft outcomes in elderly kidney transplant recipients. Kidney Int Rep 6(3):727–736

    Article  PubMed  Google Scholar 

  15. da CRincon Cintra Cruz P et al (2020) Donor age amplifies the detrimental effects of cold ischemia time on long-term kidney allograft survival independently of the occurrence of delayed graft function or early acute rejection. Exp Clin Transplant 18(4):436–443

    Article  Google Scholar 

  16. Salahudeen AK, Haider N, May W (2004) Cold ischemia and the reduced long-term survival of cadaveric renal allografts. Kidney Int 65(2):713–718

    Article  PubMed  Google Scholar 

  17. Sorensen VR et al (2016) survival benefit in renal transplantation despite high comorbidity. Transplantation 100(10):2160–2167

    Article  PubMed  Google Scholar 

  18. Kidney disease: improving global outcomes transplant work, G., KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant, 9(Suppl 3):S1–155 (2009)

  19. Rangaswami J et al (2019) Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies. Nephrol Dial Transplant 34(5):760–773

    Article  CAS  PubMed  Google Scholar 

  20. Pagonas N et al (2019) The impact of blood pressure variability and pulse pressure on graft survival and mortality after kidney transplantation. Clin Transplant 33(1):e13448

    Article  PubMed  Google Scholar 

  21. Jarmi T et al (2018) Pulmonary artery systolic pressure measured intraoperatively by right heart catheterization is a predictor of kidney transplant recipient survival. Ann Transplant 23:867–873

    Article  PubMed  PubMed Central  Google Scholar 

  22. Segers P, Rietzschel ER, Chirinos JA (2020) How to measure arterial stiffness in humans. Arterioscler Thromb Vasc Biol 40(5):1034–1043

    Article  CAS  PubMed  Google Scholar 

  23. Lewis JR et al (2019) Association between aortic calcification, cardiovascular events, and mortality in kidney and pancreas-kidney transplant recipients. Am J Nephrol 50(3):177–186

    Article  PubMed  Google Scholar 

  24. Detrano R et al (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358(13):1336–1345

    Article  CAS  PubMed  Google Scholar 

  25. Klassen PS et al (2002) Association between pulse pressure and mortality in patients undergoing maintenance hemodialysis. JAMA 287(12):1548–1555

    Article  PubMed  Google Scholar 

  26. Alappan HR et al (2020) vascular calcification slows but does not regress after kidney transplantation. Kidney Int Rep 5(12):2212–2217

    Article  PubMed  PubMed Central  Google Scholar 

  27. Clayton PA et al (2019) Long-term outcomes after acute rejection in kidney transplant recipients: an ANZDATA analysis. J Am Soc Nephrol 30(9):1697–1707

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Jarmi T et al (2020) The impact of different induction immunosuppressive therapy on long-term kidney transplant function when measured by iothalamate clearance. J Clin Med Res 12(12):787–793

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Leow K et al (2021) Prognostic value of abdominal aortic calcification: a systematic review and meta-analysis of observational studies. J Am Heart Assoc 10(2):e017205

    Article  PubMed  PubMed Central  Google Scholar 

  30. Benjamens S et al (2021) Aorto-iliac artery calcification and graft outcomes in kidney transplant recipients. J Clin Med 10(2):325

    Article  PubMed  PubMed Central  Google Scholar 

  31. McCormick F, Held PJ, Chertow GM (2018) The terrible toll of the kidney shortage. J Am Soc Nephrol 29(12):2775–2776

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hart A et al (2019) OPTN/SRTR 2017 annual data report: kidney. Am J Transplant 19(Suppl 2):19–123

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The study was a retrospective analysis and not funded

Author information

Authors and Affiliations

  1. Department of Transplant, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL, 32224, USA

    Tambi Jarmi, Abdullah Jebrini & Hani M. Wadei

  2. Division of Health Delivery Research, Mayo Clinic Florida, Jacksonville, USA

    Aaron C. Spaulding

  3. Department of Radiology, Mayo Clinic Florida, Jacksonville, USA

    David M. Sella & Lauren F. Alexander

  4. Division of Vascular Surgery, Mayo Clinic Florida, Jacksonville, USA

    Samuel Nussbaum, Mira Shoukry & Houssam Farres

  5. Department of Quantitative Health Sciences, Mayo Clinic Florida, Jacksonville, USA

    Launia White

Authors
  1. Tambi Jarmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aaron C. Spaulding
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abdullah Jebrini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David M. Sella
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lauren F. Alexander
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Samuel Nussbaum
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mira Shoukry
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Launia White
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hani M. Wadei
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Houssam Farres
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tambi Jarmi.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 39 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jarmi, T., Spaulding, A.C., Jebrini, A. et al. Association of Abdominal Arterial Calcification Score with Patients’ Survival and Kidney Allograft Function after Kidney Transplant. World J Surg 46, 2468–2475 (2022). https://doi.org/10.1007/s00268-022-06665-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-022-06665-z

Search

Navigation