[Vascular calcification after kidney transplantation. Preliminary results].
BACKGROUND
Vascular calcifications (VC) are a common feature in chronic dialysis patients, but their clinical significance is debated, and the role of kidney transplantation (TRP) in the natural history of their development has received only scanty attention.


METHODS
In our study we reviewed skeletal surveys as well as clinical and biochemical records of 13 patients who started again chronic dialysis at our Centre after failure of their kidney grafts. Changes of VC (during TRP) were scored as: 1 = no substantial progression (4 patients), 2 = moderate worsening (4 patients), 3 = severe worsening (5 patients = 38.4%).


RESULTS
The most interesting association with the clinical/biochemical parameters seems to be between the score 3 subgroup and highest Ca*P values and vitamin D therapy. Four out of five score 3 patients experienced overt vascular events and 4 out of 5 of the same subgroup experienced parathyroidectomy (PTX) before, during or after the TRP.


CONCLUSIONS
In this preliminary study we can conclude that a) the possibility of dramatic worsening of VC during TRP is not a rare event and this feature has a strong clinical implication, b) PTX before TRP could remove at least one of the putative risk factors in patients waiting for TRP with suboptimal control with medical therapy.
Canavese
C
C
Dipartimento di Discipline Medico-Chirurgiche, Università degli Studi, Torino.
Cesarani
F
F
Stratta
C
C
Maddalena
E
E
Messina
M
M
Segoloni
G P
GP
D000293:Adolescent; D000328:Adult; D002114:Calcinosis / Q000209:etiology*; D005260:Female; D006084:Graft Rejection; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D016105:Parathyroidectomy; D011183:Postoperative Complications; D014652:Vascular Diseases / Q000209:etiology* / Q000473:pathology; D014807:Vitamin D / Q000627:therapeutic use
D014807:Vitamin D