title: Post-transplant renal function and cardiovascular events are closely associated with the aortic calcification index in renal transplant recipients.
abstract: BACKGROUND
  The aortic calcification index (ACI) is reported to be closely associated with renal dysfunction and cardiovascular events; however, its implication in renal transplant recipients has not been well examined. In this study, we investigated the relationship between pretransplant ACI, ACI progression, post-transplant renal function, and post-transplant cardiovascular events in renal transplant recipients.
  
  
  METHODS
  The study from June 1996 to Jan 2012 included 61 renal transplant recipients (living donors, 47; cadaveric donors, 14). The median follow-up period was 60 months. ACI was quantitatively measured on abdominal computed tomography. The relationship between age, dialysis period, estimated glomerular filtration rate (eGFR), and pre- and post-transplant ACI was longitudinally evaluated. Risk factors for post-transplant ACI progression were determined by logistic regression analysis. Patient background and the incidence of post-transplant cardiovascular events were also assessed.
  
  
  RESULTS
  The pretransplant ACI (median 4.2%) significantly correlated with age at transplant, dialysis period, and diabetes mellitus. ACI gradually increased up to 2.8 times at 10 years after transplantation. Post-transplant eGFR significantly correlated with ACI progression in patients with chronic kidney disease of stage ≥ 3. Logistic regression analyses showed that age at transplantation, post-transplant period, cadaveric donors, and post-transplant chronic kidney disease stage 3 were risk factors for post-transplant ACI progression. The pretransplant ACI was higher (median 66%) in 3 patients who experienced post-transplant cardiovascular events.
  
  
  CONCLUSIONS
  ACI progression closely correlates with age and post-transplant renal function. A high pretransplant ACI is a risk factor for post-transplant cardiovascular events in renal transplant recipients.
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Imanishi
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. Electronic address: shingorilla2@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Hatakeyama
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Okamoto
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Imai
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yoneyama
authors.affiliation: Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Koie
authors.affiliation: Department of Cardiology, Respiratory Medicine and Nephrology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fujita
authors.affiliation: Department of Cardiology, Respiratory Medicine and Nephrology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Murakami
authors.affiliation: Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Saitoh
authors.affiliation: Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Funyu
authors.affiliation: Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Narumi
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Ohyama
mesh_terms: D000328:Adult; D001011:Aorta / Q000473:pathology*; D002102:Cadaver; D002114:Calcinosis; D002319:Cardiovascular System / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged