TY - JOUR
T1 - Impact of Arterial Calcification on Cardiovascular and Renal Outcomes in Kidney Transplant Patients
AU - on behalf of the KNOW-KT Study Group
AU - Ha, Joohyung
AU - Jeong, Jong Cheol
AU - Ryu, Jung Hwa
AU - Kim, Myung Gyu
AU - Huh, Kyu Ha
AU - Lee, Kyo Won
AU - Jung, Hee Yeon
AU - Kang, Kyung Pyo
AU - Ro, Han
AU - Han, Seungyeup
AU - Seok Kim, Beom
AU - Yang, Jaeseok
N1 - Publisher Copyright:
© 2024 The Author(s). Published by S. Karger AG, Basel.
PY - 2024/4/16
Y1 - 2024/4/16
N2 - Introduction: Coronary artery calcification score (CACS) and abdominal aortic calcification score (AACS) are both wellestablished markers of vascular stiffness, and previous studies have shown that a higher CACS is a risk factor for chronic kidney disease (CKD) progression. However, the impact of pretransplant CACS and AACS on cardiovascular and renal outcomes in kidney transplant patients has not been established. Methods: We included 944 kidney transplant recipients from the KoreaN cohort study for Outcome in patients With Kidney Transplantation (KNOWKT) cohort and categorized them into three groups (low, medium, and high) according to baseline CACS (0, 0 < and ≥100, >100) and AACS (0, 1.4, >4). The low (0), medium (0 < and ≥ 100), and high (>100) CACS groups each consisted of 462, 213, and 225 patients, respectively. Similarly, the low (0), medium (1.4), and high (>4) AACS groups included 638, 159, and 147 patients, respectively. The primary outcome was the occurrence of cardiovascular events. The secondary outcomes were all-cause mortality and composite kidney outcomes, which comprised of >50% decline in the estimated glomerular filtration rate and graft loss. Cox regression analysis was used to investigate the association between baseline CACS/AACS and outcomes. Results: The high CACS group (N = 462) faced a significantly higher risk for cardiovascular outcomes (adjusted hazard ratio [aHR], 5.97; 95% confidence interval [CI], 2.01-17.7) and all-cause mortality (aHR, 2.74; 95% CI, 1.27-5.92) compared to the low CACS group (N = 225). Similarly, the high AACS group (N = 638) had an elevated risk for cardiovascular outcomes (aHR, 2.38; 95% CI, 1.16-4.88). Furthermore, the addition of CACS to prediction models improved prediction indices for cardiovascular outcomes. However, the risk of renal outcomes did not differ among CACS or AACS groups. Conclusion: Pretransplant arterial calcification, characterized by high CACS or AACS, is an independent risk factor for cardiovascular outcomes and mortality in kidney transplant patients.
AB - Introduction: Coronary artery calcification score (CACS) and abdominal aortic calcification score (AACS) are both wellestablished markers of vascular stiffness, and previous studies have shown that a higher CACS is a risk factor for chronic kidney disease (CKD) progression. However, the impact of pretransplant CACS and AACS on cardiovascular and renal outcomes in kidney transplant patients has not been established. Methods: We included 944 kidney transplant recipients from the KoreaN cohort study for Outcome in patients With Kidney Transplantation (KNOWKT) cohort and categorized them into three groups (low, medium, and high) according to baseline CACS (0, 0 < and ≥100, >100) and AACS (0, 1.4, >4). The low (0), medium (0 < and ≥ 100), and high (>100) CACS groups each consisted of 462, 213, and 225 patients, respectively. Similarly, the low (0), medium (1.4), and high (>4) AACS groups included 638, 159, and 147 patients, respectively. The primary outcome was the occurrence of cardiovascular events. The secondary outcomes were all-cause mortality and composite kidney outcomes, which comprised of >50% decline in the estimated glomerular filtration rate and graft loss. Cox regression analysis was used to investigate the association between baseline CACS/AACS and outcomes. Results: The high CACS group (N = 462) faced a significantly higher risk for cardiovascular outcomes (adjusted hazard ratio [aHR], 5.97; 95% confidence interval [CI], 2.01-17.7) and all-cause mortality (aHR, 2.74; 95% CI, 1.27-5.92) compared to the low CACS group (N = 225). Similarly, the high AACS group (N = 638) had an elevated risk for cardiovascular outcomes (aHR, 2.38; 95% CI, 1.16-4.88). Furthermore, the addition of CACS to prediction models improved prediction indices for cardiovascular outcomes. However, the risk of renal outcomes did not differ among CACS or AACS groups. Conclusion: Pretransplant arterial calcification, characterized by high CACS or AACS, is an independent risk factor for cardiovascular outcomes and mortality in kidney transplant patients.
KW - Aortic artery calcification
KW - Cardiovascular disease
KW - Coronary artery calcification
KW - Kidney transplantation
KW - Renal outcome
UR - http://www.scopus.com/inward/record.url?scp=85196672440&partnerID=8YFLogxK
U2 - 10.1159/000538929
DO - 10.1159/000538929
M3 - Article
AN - SCOPUS:85196672440
SN - 2296-9381
VL - 10
SP - 249
EP - 261
JO - Kidney Diseases
JF - Kidney Diseases
IS - 4
ER -
