Bergmann, Ivo

Bienholz, Anja

Eisenberger, Ute

Farese, Stefan

Pasch, Andreas

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RENALTRANSPLANTATION. CLINICAL - 1FP883 SERUMCALCIFICATION PROPENSITY IS ASSOCIATEDWITHRENAL RESISTANCE INDEX ANDMORTALITY AFTER RENALTRANSPLANTATIONUte Eisenberger1, Stefan Farese2, Ivo Bergmann2, Anja Bienholz1 andAndreas Pasch21University Hospital Essen-Duisburg, Nephrology, Essen, Germany, 2UniversityHospital Bern, Nephrology, Bern, SwitzerlandIntroduction and Aims: Death with a functioning graft due to cardiovascular disease isthe one of the most important issues in renal transplantation. Medial arterialcalcification is accelerated in patients with chronic kidney disease and closely associatedwith arterial stiffness and mortality. Recently, we developed a novel in vitro blood testthat provides an overall measure of calcification propensity by monitoring maturationtime (T 50) of calciprotein particles in serum. The current study elucidates clinical andhemodynamic factors influencing calcification propensity and analyses the value of T50measurements for prediction of patient and graft survival after renal transplantation.Methods:We measured T50 in a prospective single centre cohort of 198 renaltransplant patients with a follow-up of 5 years. Mean time after transplantation at studyinclusion was on average 7 years. T 50 measurements were performed using aNephelostar nephelometer (BMG Labtech, Offenurg, Germany) as previously described(Pasch et al. JASN 2012). Renal resistance index was measured by color-coded duplexultrasound. All hemodynamic and laboratory measurements were performed at studyinclusion.Results: At baseline the major determinants for tertiles of T50 included higher serumphosphate (p<0.001), lower transplant function (p<0.001) and serum albumin(p<0.01), higher HbA1C (p<0.05) and total cholesterol (p<0.01), higher pulsepressure (p<0.05), systolic blood pressure (p<0.05) and renal resistance index(p<0.05) as well as the use of Calcineurin inhibitors (p=0.02). In a multivariateanalysis, increased serum calcification propensity was independently associated withhigher serum phosphate (p<0.001), lower serum albumin (p<0.005), higher HbA1C(p<0.05), total cholesterol (p<0.05) and interestingly with use of Calcineurininhibitors (p<0.05). Patient and graft survival divided by tertiles of T50 has beennegatively associated with highest calcification propensity corresponding to thelowest tertile of T50 (log rank p=0.03, p=0.02, respectively). The lowest tertile of ofT50 revealed a more than 3 times increased relative risk for mortality compared tothe highest tertile.Conclusions: Our results suggest that serum T 50 is associated to established and newcardiovascular risk markers such as renal resistance index. T 50 may be a valuablebiomarker to evaluate cardiovascular mortality risk in renal transplantation andmight guide adjusted therapy in the future.© The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.Nephrology Dialysis Transplantation 30 (Supplement 3): iii348–iii376, 2015doi:10.1093/ndt/gfv185.72

FP883SERUM CALCIFICATION PROPENSITY IS ASSOCIATED WITH RENAL RESISTANCE INDEX AND MORTALITY AFTER RENAL TRANSPLANTATION

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FP883SERUM CALCIFICATION PROPENSITY IS ASSOCIATED WITH RENAL RESISTANCE INDEX AND MORTALITY AFTER RENAL TRANSPLANTATION

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