Share This Article:

Modifications of Coronay Artery Calcifications (CAC) and Correlations with C Reactive Protein (CRP) Levels in Renal Recipients after the First Year of Transplantation

DOI: 10.4236/ojneph.2013.31001    2,656 Downloads   5,082 Views   Citations

ABSTRACT

The purpose of the present study was to determine the association between presence and progression of Coronary Artery Calcifications (CAC) quantified with Agatston Score (AS) and inflammatory index as CRP and other parameters in unselected renal transplant recipients. Forty-five patients were underwent a baseline Multislice CT (MSCT) at the time of renal transplant and a repeat evaluation 12 - 16 months later. After second MSCT recipients were divided in three groups: Gr1 (26 patients) with absence of CAC at basal and second MSCT, Gr2 (11 patients) with reduction of CAC after one year and Gr3 (8 patients) with increased values of CAC after one year. Mean +/- Standard deviation of basal and after one year values of AS and CRP were respectively: Gr1: 2 +/-3; 2 +/- 5 and 0.4 +/- 0.3; 0.55 +/- 0.67; Gr2: 317 +/- 288; 212 +/- 242 and 0.9 +/- 1.1; 0.55 +/- 0.6; Gr3: 854 +/- 1168; 1032 +/- 1153 and 0.8 +/- 0.8; 1.1 +/- 0.96. We found capacity of renal transplantation to protect against development of new calcium deposits in recipients without CAC at time of transplantation. While we confirmed association in Gr2 between reduction of CAC with reduction of CRP levels and in Gr3 between increased levels of CRP with increasing of CAC. Conclusion: In this preliminary study, renal transplantation appears to slow down or increasing CAC, in strict association with modifications of CRP levels. Long term studies are needed to confirm our preliminary data and to determine the effects of CAC on cardiovascular morbidity and mortality in renal transplant recipients.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Paolis, P. , Colonnelli, R. , Favarò, A. , Iappelli, M. , Carriero, C. , Mantella, D. , Coen, G. and Giulio, S. (2013) Modifications of Coronay Artery Calcifications (CAC) and Correlations with C Reactive Protein (CRP) Levels in Renal Recipients after the First Year of Transplantation. Open Journal of Nephrology, 3, 1-5. doi: 10.4236/ojneph.2013.31001.

References

[1] S. Jono, M. D. McKee, C. E. Murry, et al., “Phosphate Regulation of Vascular Smooth Muscle Cell Calcification,” Circulation Research, Vol. 87, 2000, pp. e10-e17. doi:10.1161/01.RES.87.7.e10
[2] H. Yang, G. Curinga, C. M. Giachelli, et al., “Elevated Extracellular Calcium Levels Induce Smooth Muscle Cell Matrix Mineralization in Vitro,” Kidney International, Vol. 66, 2004, pp. 2293-2299. doi:10.1111/j.1523-1755.2004.66015.x
[3] K. Lomashvili, P. Garg, W. C. O’Neil, et al., “Chemical and Hormonal Determinants of Vascular Calcification in Vitro,” Kidney International, Vol. 69, No. 8, 2006, pp. 1464-1470.
[4] M. Ketteler, P. Borgantz, R. Westenfeld, et al., “Association of Low Fetuin-A (AHSG) Concentrations in Serum with Cardiovascular Mortality in Patients on Dialysis: A Cross-Sectional Study,” Lancet, Vol. 361, No. 9360, 2003, pp. 827-833. doi:10.1016/S0140-6736(03)12710-9
[5] P. Stenvinkel, K. Wang, A. R. Qureshi, et al., “Low Fetuin-A Levels Are Associated with Cardiovascular Death: Impact of Variations in the Gene Encoding Fetuin,” Kidney International, Vol. 67, No. 6, 2005, pp. 2283-2392.
[6] B. L. Kasisle, “Cardiovascular Disease after Renal Transplantation,” Seminars in Nephrology, Vol. 20, 2000, pp. 176-187.
[7] W. G. Goodman, J. Goldin, B. D. Kuizon, et al., “Coronary-Artery Calcifictaqion in Young Adults with End- Stage Renal Disease Who Are Undergoing Dialysis,” New England Journal of Medicine, Vol. 342, 2000, pp. 1478-1483. doi:10.1056/NEJM200005183422003
[8] M. B. Ishitani, D. S. Milliner, D. Y. Kim, et al., “Early Subclinical Coronary Artery Calcification in Young Adults Who Were Pediatric Kidney Transplant Recipients,” American Journal of Transplantation, Vol. 5, No. 7, 2005, pp. 1689-1693. doi:10.1111/j.1600-6143.2005.00914.x
[9] P. A. McCullogh, K. R. Sandberg, F. Dumler, et al., “Determinants of Coronary Vascular Calcification in Patients with Chronic Kidney Disease and End-Stage Renal Disease: A Systenmatic Review,” Journal of Nephrology, Vol. 17, No. 2, 2004, pp. 205-215.
[10] P. T. Nguyen, E. Coche, E. Goffin, et al., “Prevalence and Determinants of Coronary and Aortic Calcifications Assessed by Chest CT in Renal Transplant Recipients,” American Journal of Nephrology, Vol. 27, No. 4, 2007, pp. 329-335. doi:10.1159/000102978
[11] K. Nitta, T. Akiba, K. Suzuki, et al., “Assessment of Coronary Artery Calcification in Hemodialysis Patients Using Multi-Detector Spiral CT Scan,” Hypertension Research, Vol. 27, No. 8, 2004, pp. 527-533. doi:10.1291/hypres.27.527
[12] S. E. Rosas, K. Mensah, R. B. Weinstein, et al., “Coronary Artery Calcification in Renal Transplant Recipients,” American Journal of Transplantation, Vol. 5, No. 8, 2005, pp. 1942-1945.
[13] P. T. Nguyen, S. Henrard, E. Coche, et al., “Coronary Artery Calcification: A Strong Predictor of Cardiovascular Events in Renal Transplant Recipients,” Nephrology Dialysis Transplantation, Vol. 25, No. 11, 2010, pp. 3773-3778.
[14] S. Mazzaferro, M. Pasquali, F. Taggi, et al., “Progression of Coronary Artery Calcification in Renal Transplantation and the Role of Secondary Hyperparathyroidism and Inflammation,” Clinical Journal of the American Society of Nephrology, Vol. 4, No. 3, 2009, pp. 685-690. doi:10.2215/CJN.03930808
[15] J. Braum, M. Oldendorf, W. Moshage, et al., “Electron Beam Computed Tomography in the Evaluation of Cardiac Calcification in Chronic Dialysis Patients,” American Journal of Kidney Diseases, Vol. 27, No. 3, 1996, pp. 394-401. doi:10.1016/S0272-6386(96)90363-7
[16] G. M. London, A. P. Guerin, S. J. Marchais, et al., “Arterial Media Calcification in End-Stage Renal Disease: Impact on All-Cause and Cardiovascular Mortality,” Nephrology Dialysis Transplantation, Vol. 18, No. 9, 2003, pp. 1731-1740. doi:10.1093/ndt/gfg414
[17] G. M. Chertow, S. K. Burke and P. Raggi, “Sevelamer Attenuates the Progression of Coronary and Aortic Calcification in Hemodialysis Patients,” Kidney International, Vol. 62, No. 1, 2002, pp. 245-252. doi:10.1046/j.1523-1755.2002.00434.x
[18] S. M. Moe, K. D. O’Neill, N. Fineberg, et al., “Assessment of Vascular Calcifictaions in ESRD Patients Using Spiral CT,” Nephrology Dialysis Transplantation, Vol. 18, No. 6, 2003, pp. 1152-1158. doi:10.1093/ndt/gfg093
[19] G. Coen, P. De Paolis, P. Ballanti, et al., “Peripheral Artery Calcifications Evaluated by Histology Correlate to Those Detected by CT: Relationships with Fetuin-A and FGF-23,” Journal of Nephrology, Vol. 24, No. 3, 2011, pp. 313-321.
[20] C. Marechal, G. Schlieper, P. Nguyen, et al., “Serum Fetuin-A Levels Are Associated with Vascular Calcifications and Predict Cardiovascular Events in Renal Transplant Recipients,” Clinical Journal of the American Society of Nephrology, Vol. 6, No. 5, 2011, pp. 974-985.

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.