title: Pretransplant calcium levels have no predictive value for delayed graft function, long-term graft function, cardiovascular events, or graft and patient survival in renal transplantation.
abstract: BACKGROUND
  Disorders of calcium homeostasis are one of the most common problems in patients with end-stage renal disease (ESRD). Elevated calcium levels increase the incidence of cardiovascular mortality in ESRD patients, and appear to be a risk factor for the occurrence of delayed graft function (DGF) after kidney transplantation. Therefore, we investigated the impact of pretransplant serum calcium levels on outcomes after kidney transplantation: DGF, acute rejection, graft function, and survival, as well as the incidence of cardiovascular events.
  
  
  METHODS
  We studied 285 patients (96.9% of all transplanted patients) who underwent their first transplantation between 1995 and 2004. Demographic data were extracted from hospital records or were documented during follow-up; serum samples were collected at the time of transplantation.
  
  
  RESULTS
  In our cohort the incidence of DGF was 16.5% and 35.4% of acute rejection episodes (ARE). However, pretransplant calcium levels were not related to DGF or ARE in our patient cohort. Furthermore, there was no correlation between pretransplant serum calcium level with the incidence of cardiovascular events or mortality, as well as graft function or survival.
  
  
  CONCLUSIONS
  In our study population pretransplant calcium levels showed no effect on DGF, ARE rate, the occurrence of cardiovascular events or death, renal graft function, or survival. Therefore, pretransplant calcium level is not a helpful marker for risk stratification at the time of transplantation.
authors.affiliation: Klinik und Poliklinik für Innere Medizin II, Nephrologie, Universität Regensburg, Regensburg, Germany. Bernd.Krueger@klinik.uni-regensburg.de
authors.forename: B
authors.initials: B
authors.lastname: Krüger
authors.forename: A A
authors.initials: AA
authors.lastname: Schnitzbauer
authors.forename: C A
authors.initials: CA
authors.lastname: Böger
authors.forename: U
authors.initials: U
authors.lastname: Hoffmann
authors.forename: B
authors.initials: B
authors.lastname: Banas
authors.forename: S
authors.initials: S
authors.lastname: Farkas
authors.forename: H J
authors.initials: HJ
authors.lastname: Schlitt
authors.forename: A
authors.initials: A
authors.lastname: Obed
authors.forename: B K
authors.initials: BK
authors.lastname: Krämer
mesh_terms: D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D002118:Calcium