Imanishi K, Hatakeyama S, Yamamoto H, Okamoto A, Imai A, Yoneyama T, Hashimoto Y, Koie T, Fujita T, Murakami R, Saitoh H, Funyu T, Narumi S, Ohyama C
Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Transplant Proc. 2014;46(2):484-8. doi: 10.1016/j.transproceed.2013.09.039.
The aortic calcification index (ACI) is reported to be closely associated with renal dysfunction and cardiovascular events; however, its implication in renal transplant recipients has not been well examined. In this study, we investigated the relationship between pretransplant ACI, ACI progression, post-transplant renal function, and post-transplant cardiovascular events in renal transplant recipients.
The study from June 1996 to Jan 2012 included 61 renal transplant recipients (living donors, 47; cadaveric donors, 14). The median follow-up period was 60 months. ACI was quantitatively measured on abdominal computed tomography. The relationship between age, dialysis period, estimated glomerular filtration rate (eGFR), and pre- and post-transplant ACI was longitudinally evaluated. Risk factors for post-transplant ACI progression were determined by logistic regression analysis. Patient background and the incidence of post-transplant cardiovascular events were also assessed.
The pretransplant ACI (median 4.2%) significantly correlated with age at transplant, dialysis period, and diabetes mellitus. ACI gradually increased up to 2.8 times at 10 years after transplantation. Post-transplant eGFR significantly correlated with ACI progression in patients with chronic kidney disease of stage ≥ 3. Logistic regression analyses showed that age at transplantation, post-transplant period, cadaveric donors, and post-transplant chronic kidney disease stage 3 were risk factors for post-transplant ACI progression. The pretransplant ACI was higher (median 66%) in 3 patients who experienced post-transplant cardiovascular events.
ACI progression closely correlates with age and post-transplant renal function. A high pretransplant ACI is a risk factor for post-transplant cardiovascular events in renal transplant recipients.
据报道，主动脉钙化指数（ACI）与肾功能不全和心血管事件密切相关；然而，其在肾移植受者中的意义尚未得到充分研究。在本研究中，我们调查了肾移植受者移植前ACI、ACI进展、移植后肾功能和移植后心血管事件之间的关系。
该研究纳入了1996年6月至2012年1月期间的61例肾移植受者（活体供者47例；尸体供者14例）。中位随访期为60个月。通过腹部计算机断层扫描对ACI进行定量测量。纵向评估年龄、透析时间、估计肾小球滤过率（eGFR）与移植前后ACI之间的关系。通过逻辑回归分析确定移植后ACI进展的危险因素。还评估了患者背景和移植后心血管事件的发生率。
移植前ACI（中位数4.2%）与移植时年龄、透析时间和糖尿病显著相关。移植后10年，ACI逐渐增加至2.8倍。在≥3期慢性肾脏病患者中，移植后eGFR与ACI进展显著相关。逻辑回归分析显示，移植时年龄、移植后时间、尸体供者以及移植后慢性肾脏病3期是移植后ACI进展的危险因素。3例发生移植后心血管事件的患者移植前ACI较高（中位数66%）。
ACI进展与年龄和移植后肾功能密切相关。移植前高ACI是肾移植受者移植后心血管事件的危险因素。
