Renal transplantation does not stop or reverse coronary artery calcification (CAC), according to researchers.
In a study that included 150 renal transplant recipients, CAC prevalence increased from 35.3% with a mean score of 60.0% to 64.6% with a mean score of 94.9 after about 2.8 years of follow-up. At a baseline scan, 34 patients with no baseline CAC converted to a positive score at follow-up, for an incidence rate of about 12.5% a year.
In addition to baseline CAC score, higher triglyceride level and bisphosphonate use were associated with CAC progression. Other lipid parameters such as low-density lipoprotein (LDL) cholesterol had a negative association with CAC in patients.
Headed by Nurhan Seyahi, MD, the authors published their findings in Nephrology Dialysis Transplantation (published online ahead of print). To their knowledge, this was the largest study with the longest follow-up to examine CAC progression in renal transplant recipients.
Only two renal transplant patients (1.3%) had a regression in CAC score, a finding that contrasts with a previous study in which 14.5% of patients experience regression.
The researchers noted that while they lacked a control group, CAC progression in non-kidney disease patients is lower in accordance with previous studies that report a 6.6% incidence rate per year.
The researchers stated that further analysis of these associations is necessary to develop strategies that prevent progression of CAC in kidney disease patients, and that “renal transplantation can improve CAC in some patients in the short term but in the long term, progression is the usual process.”