title: Vascular calcification in patients undergoing kidney and simultaneous pancreas-kidney transplantation.
abstract: OBJECTIVE
  Vascular calcification (VC) is common in patients with chronic kidney disease (CKD) on dialysis, and an inverse relationship of VC to bone mineral density (BMD) has been reported. Because elderly patients are prone to atherosclerosis and BMD artefact, we examined the prevalence and epidemiology of VC in younger patients undergoing transplantation, and its relationship to BMD.
  
  
  METHODS
  Laboratory testing was performed immediately before kidney or simultaneous pancreas-kidney (SPK) transplantation. Within 4 weeks patients underwent BMD evaluation and lateral abdominal X-ray. Aortic calcification was scored using a validated 24-point scale.
  
  
  RESULTS
  Of 650 consecutive patients X-rays were available for 531 (82%). Their median age was 41 years (16-71), 58% were male, dialysis vintage was 20 months (0-402) and 69% had kidney and 31% SPK transplants. VC scores were ≥1 in 47%, with the median score 6 (1-24) and was associated with age, dialysis vintage and presence of cardiovascular, cerebrovascular or peripheral vascular disease. In a multivariate analysis of patients with and without VC, those with VC were older and of longer dialysis vintage (OR 1.07 and 1.17 per 12 months respectively; P < 0.001 for both). In that analysis, VC was not significantly associated with gender, transplant type, presence of diabetes, current or former smoking or calcium or calcitriol therapy, and was not inversely related to hip, spine or forearm BMD Z-scores.
  
  
  CONCLUSIONS
  VC is common in younger patients undergoing transplantation and, similar to older patients, is associated with age, dialysis vintage and cardiovascular pathology. However, in this younger patient group, there was no significant inverse association of VC to BMD.
authors: Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
authors: Katrina
authors: K
authors: Chau
authors: Gabriela
authors: G
authors: Martinez
authors: Grahame J
authors: GJ
authors: Elder
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015519:Bone Density; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009517:New South Wales / Q000453:epidemiology; D016017:Odds Ratio; D016035:Pancreas Transplantation; D015995:Prevalence; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D012307:Risk Factors; D061205:Vascular Calcification / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
keywords: bone mineral density; cardiovascular disease; renal failure; transplantation; vascular calcification