Vascular calcification is a strong predictor of cardiovascular and all-cause mortality. Coronary artery calcification is more frequent, more extensive and progresses more rapidly in CKD than in general population. It is also considered a marker of coronary heart disease, the main cause of increased morbidity and mortality in patients on maintenance hemodialysis and transplanted patients. The aim of this study was evaluation of effect of renal transplantation on calcium scoring of coronary arteries of hemodialysis patients. The study included 23 patients (13 M, 10 F) aged 19-56 years (mean = 38.08+/- 13.49 y) hemodialyzed three times a week for 6 to 49 months (mean = 20+/-15.72m) whom underwent renal transplantation (RTX). The homocysteine, iPTH, calcium, phosphate and indices of lipid metabolism such as total cholesterol, HDL, LDL, triglycerides, were measured before and 6 months after RTX. To evaluate the coronary artery calcification, all patients underwent MDCT coronary CT using agatston technique calcium scoring (CS) and color Doppler ultrasound for IMT before & 6 month after RTX. Coronary artery calcifications prevalence was of 96% of dialysis patients with total CS ranged from 0 to 198, affecting more than two vessels inmore than 50% with higher calcium score level at left anterior descending(LAD). Mean total ca scoring was decreased significantly from pre RTX (39.82+/-63.05) to (24.34+/- 39.55) post RTX p < 0.001.Ca scoring was decreased from pre RTX (7.4 +/_ 13.03) to (4.3+/_8.54) post RTX p < 0.01 in left main artery and from pre RTX (15.76+/_23.53 ) to (10.23 +/_ 15.81) post RTX p<0.01in LAD & from pre RTX (7.8+/_14.98) to (5.1 +/_9.57 ) post RTX p < 0.001 in Circomflex & from pre RTX (9.2 +/_17.18 ) to (4.7+/_8.18 ) post RTX p < 0.01 in right coronary. The CS correlated significantly with age (r = 0.39; p < 0.005), P (r = 0.33; p < 0.05), CaxP product (r = 0.39; p < 0.05), iPTH (r = 0.43; p < 0.001) and with IMT (r = 0.56; p < 0.0001) before RTX. There was linear & meaningful correlation between CS and iPTH & ca- p product reduction after RTX. Renal transplantation reduces significantly coronary artery calcification of dialysis patients and it linearly correlate with decrease in iPTH & ca & p product at early period after renal transplantation.
Volume : 6
Issue : 4
Pages : 150
Department s of Radiology and Nephrology Tabriz University of Medical Sciences, and Young researchers Club, Tabriz Islamic Azad University Tabriz, Tabriz, Iran.