ORIGINAL ARTICLES   

Minerva Urologica e Nefrologica 1999 March;51(1):11-5

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Vascular calcifications after kidney transplantation. Preliminary results

Canavese C., Cesarani F., Stratta C., Maddalena E., Messina M., Segoloni G. P.

Università degli Studi - Torino Dipartimento di Discipline Medico-Chirurgiche Sezioni di Nefro-Urologia e di *Scienze Radiologiche

Background. Vascular calcifications (VC) are a common feature in chronic dialysis patients, but their clinical significance is debated, and the role of kidney transplantation (TRP) in the natural history of their development has received only scanty attention.
Methods. In our study we reviewed skeletal surveys as well as clinical and biochemical records of 13 patients who started again chronic dialysis at our Centre after failure of their kidney grafts. Changes of VC (during TRP) were scored as: 1=no substantial progression (4 patients), 2=moderate worsening (4 patients), 3=severe worsening (5 patients=38.4%).
Results. The most interesting association with the clinical/ biochemical parameters seems to be between the score 3 subgroup and highest Ca*P values and vitamin D therapy. Four out of five score 3 patients experienced overt vascular events and 4 out of 5 of the same subgroup experienced parathyroidectomy (PTX) before, during or after the TRP.
Conclusions. In this preliminary study we can conclude that a) the possibility of dramatic worsening of VC during TRP is not a rare event and this feature has a strong clinical implication, b) PTX before TRP could remove at least one of the putative risk factors in patients waiting for TRP with suboptimal control with medical therapy.