Dahle, Dag Olav

Dionisi, Mauro

Hartmann, Anders

Holdaas, Hallvard

Jenssen, Trond Geir

Pasch, Andreas

Åsberg, Anders

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CLINICALTRANSPLANTATIONSaO031 SERUMCALCIFICATION PROPENSITY PREDICTSMORTALITY IN KIDNEY TRANSPLANT RECIPIENTSDag Olav Dahle1,2, Anders Åsberg1,3, Anders Hartmann1, Hallvard Holdaas1,Trond Geir Jenssen1,4, Mauro Dionisi5 and Andreas Pasch61Oslo University Hospital, Department of Transplant Medicine, Oslo, Norway,2University of Oslo, Medical Faculty, Oslo, Norway, 3University of Oslo, School ofPharmacy, Oslo, Norway, 4UiT The Arctic University of Norway, Metabolic andRenal Research Group, Tromsø, Norway, 5Calcisco SA, Bern, Bern, Switzerland,6University Hospital Bern, Department of Clinical Chemistry, Bern, SwitzerlandIntroduction and Aims: Kidney transplant recipients are at increased risk ofcardiovascular disease compared with the general population. In CKD, acceleratedcalcification contributes to arterial stiffness andmortality. A blood test for calcificationpropensity was recently developed by measuring the maturation time (T50) of calciproteinparticles in serum, with a lower T50 corresponding to a higher calcification propensity. Theprognostic implication of T50 in kidney transplant recipients is not known.Methods:Wemeasured T50 in biobanked blood obtained 10 weeks after transplantationduring two eras, 2000-2003 and 2009-2012. Survival was assessed in Cox regressionmodels, adjusting for age, gender and clinical correlates of T50 including era, diabetesincluding post-transplant diabetes, first kidney recipient, deceased donor kidney, rejection,cytomegalovirus infection, eGFR, phosphate, prednisolone dose ≥12.5 mg and highestquartile of calcineurin inhibitor trough levels (TAC >8.5 or CsA >220 ng/mL). AlthoughT50 was lower during the first era, there was no interaction between era and T50 regardingsurvival and the cohorts were combined in the survival analyses. Patients with missingvalues (1%) were excluded from the multivariable model. Due to non-linearity, T50 wasmodeled as quartiles with median levels at 111, 165, 216 and 287 minutes, respectively.Results:Of 1886 eligible adult kidney or kidney-pancreas recipients during the two eras,1435 (76%) had T50 measured. Hospital staff shortage excluded 161 patients and 290 weretransferred to other hospitals before the investigation in week 10.The cohort was primarily Caucasian with mean age 52 ± 14 years, eGFR 57 ± 19 ml/min/1.73m2, male 66%, diabetes 29.1% including 9.3% post-transplant diabetes, simultaneouspancreas transplant 6% and T50 196 ± 72 minutes.Median (25th, 75th percentile) follow-up was 5.1 (3.5, 11.6) years. All-cause andcardiovascular mortality occurred in 283 and 104 patients, respectively. As shown in thetable, lower quartiles of T50 were strongly associated with both endpoints.SaO031 Table 1: Survival modelsAge- and gender adjustedHR (95% CI), p-valueMultivariableHR (95% CI), p-valueAll-cause mortalityQ1 2.12 (1.43-3.14), <0.001 1.80 (1.13-2.87), 0.01Q2 2.07 (1.39-3.06), <0.001 1.93 (1.28-2.92), 0.002Q3 1.51 (0.99-2.30), 0.06 1.38 (0.90-2.12), 0.14Q4 Reference ReferenceCardiovascular mortalityQ1 5.02 (1.96-12.87), 0.001 4.18 (1.49-11.76), 0.01Q2 6.31 (2.49-15.98), <0.001 5.66 (2.18-14.73), <0.001Q3 4.24 (1.62-11.08), 0.003 3.73 (1.41-9.86), 0.01Q4 Reference ReferenceQ, quartile of T50.Conclusions: Serum calcification propensity T50 is strongly associated with all-causeand cardiovascular mortality in kidney transplant recipients.© The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.Nephrology Dialysis Transplantation 30 (Supplement 3): iii36–iii37, 2015doi:10.1093/ndt/gfv151.3

SaO031SERUM CALCIFICATION PROPENSITY PREDICTS MORTALITY IN KIDNEY TRANSPLANT RECIPIENTS

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SaO031SERUM CALCIFICATION PROPENSITY PREDICTS MORTALITY IN KIDNEY TRANSPLANT RECIPIENTS

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