title: Progression of coronary artery calcification in renal transplant recipients.
abstract: BACKGROUND
  Cardiovascular disease is the leading cause of mortality among renal transplant recipients. In the general population, coronary artery calcification (CAC) and progression of CAC are predictors of future cardiac risk. We conducted a study to determine the progression of CAC in renal transplant recipients; we also examined the factors associated with progression and the impact of the analytic methods used to determine CAC progression.
  
  
  METHODS
  We used multi-detector computed tomography to examine CAC in 150 prevalent renal transplant recipients, who did not have a documented cardiovascular disease. A baseline and a follow-up scan were performed and changes in CAC scores were evaluated in each patient individually, to calculate the incidence of CAC progression. Multivariate logistic regression analysis was used to evaluate the determinants of CAC progression.
  
  
  RESULTS
  Baseline CAC prevalence was 35.3% and the mean CAC score was 60.0 ± 174.8. At follow-up scan that was performed after an average of 2.8 ± 0.4 years, CAC prevalence increased to 64.6% and the mean CAC score to 94.9 ± 245.7. Progression of individual CAC score was found between 28.0 and 38.0%, depending on the method used to define progression. In patients with baseline CAC, median annualized rate of CAC progression was 11.1. Baseline CAC, high triglyceride and bisphosphonate use were the independent determinants of CAC progression.
  
  
  CONCLUSIONS
  Renal transplantation does not stop or reverse CAC. Progression of CAC is the usual evolution pattern of CAC in renal transplant recipients. Beside baseline CAC, high triglyceride level and bisphosphonate use were associated with progression of CAC.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. nseyahi@yahoo.com
authors.forename: Nurhan
authors.initials: N
authors.lastname: Seyahi
authors.forename: Deniz
authors.initials: D
authors.lastname: Cebi
authors.forename: Mehmet R
authors.initials: MR
authors.lastname: Altiparmak
authors.forename: Canan
authors.initials: C
authors.lastname: Akman
authors.forename: Rezzan
authors.initials: R
authors.lastname: Ataman
authors.forename: Salih
authors.initials: S
authors.lastname: Pekmezci
authors.forename: Kamil
authors.initials: K
authors.lastname: Serdengecti
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002114:Calcinosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D004164:Diphosphonates / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D036542:Tomography, Spiral Computed; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; D004164:Diphosphonates; D014280:Triglycerides