title: Early subclinical coronary artery calcification in young adults who were pediatric kidney transplant recipients.
abstract: Coronary artery disease (CAD) is the leading cause of death in adults after successful kidney transplantation. Children who have undergone successful kidney transplantation are entering young adulthood; however, the prevalence and extent of CAD in this population is unknown. We conducted a pilot study in young adults with stable allograft function, who received kidney transplants as children to measure coronary artery calcification (CAC), a marker of coronary artery atherosclerosis and CAD. We evaluated 19 young adults after successful pediatric kidney transplantation for known CAD risk factors; these patients underwent noninvasive imaging with electron-beam computed tomography (EBCT) for measurement of CAC. Prevalence and quantity of CAC were then compared to asymptomatic individuals from the community. All patients had multiple risk factors for CAD. Mean age at evaluation was 32 years (range: 21-48 years). CAC is uncommon in individuals in the community in this age range; however, nearly half of our patients had CAC detected with the quantity of CAC comparable to asymptomatic individuals from the community 10-40 years older. These data suggest young adults who received pediatric kidney transplants are at increased risk for developing early CAC and need close monitoring to detect early CAD so as to prevent premature cardiac morbidity and mortality.
authors.affiliation: William J. von Liebig Transplant Center, Mayo Medical School, Foundation and Clinic, Rochester, MN, USA. Ishitani.Michael@mayo.edu
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ishitani
authors.forename: Dawn S
authors.initials: DS
authors.lastname: Milliner
authors.forename: Dean Y
authors.initials: DY
authors.lastname: Kim
authors.forename: Humberto E
authors.initials: HE
authors.lastname: Bohorquez
authors.forename: Julie K
authors.initials: JK
authors.lastname: Heimbach
authors.forename: Patrick F
authors.initials: PF
authors.lastname: Sheedy
authors.forename: Bruce Z
authors.initials: BZ
authors.lastname: Morgenstern
authors.forename: James M
authors.initials: JM
authors.lastname: Gloor
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Murphy
authors.forename: Robert D
authors.initials: RD
authors.lastname: McBane
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Bielak
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Peyser
authors.forename: Mark D
authors.initials: MD
authors.lastname: Stegall
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D014057:Tomography, X-Ray Computed