Evolution of coronary artery calcifications following kidney transplantation: relationship with osteoprotegerin levels.
We prospectively assessed the evolution of coronary artery calcification (CAC) and osteoprotegerin (OPG) levels after renal transplantation (RT). Eighty-three recipients were followed-up prospectively during 1 year. Blood was collected before (baseline) and after RT for determination of mineral metabolism parameters including OPG. CAC was measured by multidetector computed tomography at transplantation (baseline) and 1 year later. Progression of CAC was defined as a difference between the follow-up square-root transformed volume (SRV) and the baseline SRV >or= 2.5. By multivariate analysis, baseline OPG level, age and low LDL levels were significantly associated with baseline CAC. RT was accompanied by mineral metabolism improvement with a decrease of OPG from 955 [395-5652] to 527 [217-1818] pg/mL and parathyroid hormone from 94 [1-550] to 62 [16-410] pg/mL. Thirty-one percent of patients did not exhibit CAC at baseline. CAC diminished in 14.5%, stabilized in 59.2% and progressed in 26.3% of patients. Baseline CAC was associated with progression (OR 2.92 [1.02-8.36]). No significant association was found between OPG and CAC progression despite a higher baseline OPG level in progressors (1046 [456-3285]) vs. non-progressors (899 [396-5952] pg/mL). CAC at baseline, but not 1 year after RT, is independently associated with baseline OPG; posttransplant CAC progression is predicted by baseline CAC score.
Department of Biochemistry, University of Montpellier, Montpellier, France.
A-S
AS
Bargnoux
A-M
AM
Dupuy
V
V
Garrigue
I
I
Jaussent
G
G
Gahide
S
S
Badiou
I
I
Szwarc
S
S
Deleuze
H
H
Vernhet
J-P
JP
Cristol
G
G
Mourad
D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000401:mortality* / Q000473:pathology*; D003324:Coronary Artery Disease / Q000401:mortality* / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000473:pathology; D016030:Kidney Transplantation / Q000592:standards*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D053244:Osteoprotegerin / Q000097:blood*; D010281:Parathyroid Hormone / Q000097:blood; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D055815:Young Adult
D053244:Osteoprotegerin; D010281:Parathyroid Hormone; C506030:TNFRSF11B protein, human