Vascular Calcification Slows But Does Not Regress After Kidney Transplantation.
Vascular Calcification Slows But Does Not Regress After Kidney Transplantation.
复制标题
血管钙化会减慢，但在肾移植后不会退缩。
DOI：
10.1016/j.ekir.2020.09.039
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发表时间：
2020-12
影响因子：
6
通讯作者：
O'Neill WC
中科院分区：
文献类型：
--
作者：
Alappan HR;Vasanth P;Manzoor S;O'Neill WC
中动脉钙化是终末期肾病中常见的进行性病变，与不良心血管结局相关。这种病变是否可以被阻止或逆转是未知的，并通过测量肾移植前后乳腺动脉钙化的进展进行回顾性检查。动脉钙化是通过对既往肾移植患者的连续乳房X线片进行测量的，并与移植前或积极等待名单上的患者进行比较。排除移植后血清肌酐>2.0 mg/dl或华法林使用。在移植前或等待移植的34例患者中，动脉钙化的中位（四分位距）进展为12.9 mm/乳房/年（5.9至32.6），而在移植后的34例患者中，动脉钙化的中位进展仅为1.2 mm/乳房/年（-0.54至5.1）（P < 0.001）。在对移植前后进行乳房X线检查的患者进行的纵向分析中，也观察到进展减缓。移植前终末期肾病的持续时间与移植后进展相关，但与年龄、糖尿病、基线钙化或血清化学无关。在任何患者中均未观察到显著消退。在这第一个定量研究的影响，肾移植，中动脉钙化似乎减缓率在肾功能正常的患者，表明肾功能衰竭的影响可能会完全消失。然而，总体而言，没有显著的消退，表明钙化是不可逆的，并强调预防的重要性。移植前终末期肾病的持续时间而不是基线钙化是进展的决定因素，与促进钙化的动脉的累积性、永久性变化一致。
Medial arterial calcification is a common and progressive lesion in end-stage renal disease that is associated with poor cardiovascular outcomes. Whether this lesion can be arrested or reversed is unknown, and was examined retrospectively by measuring progression of breast arterial calcification before and after kidney transplantation. Arterial calcification was measured on serial mammograms from patients with previous kidney transplantation and compared to measurements performed before transplantation or in patients on the active waitlist. Serum creatinine >2.0 mg/dl after transplantation or warfarin use were exclusions. Median (interquartile range) progression of arterial calcification was 12.9 mm/breast per year (5.9 to 32.6) in 34 patients before or awaiting transplantation compared to just 1.2 mm/breast per year (−0.54 to 5.1) in 34 patients after transplantation (P < 0.001). Slowing of progression was also seen in longitudinal analyses of patients with mammograms performed both before and after transplantation. Duration of end-stage renal disease before transplantation but not age, diabetes, baseline calcification, or serum chemistries correlated with progression after transplantation. Significant regression was not observed in any patient. In this first quantitative study of the effect of kidney transplantation, medial arterial calcification appeared to slow to rates seen in patients with normal renal function, indicating that the effect of renal failure may be completely abrogated. Overall, however, there was no significant regression, suggesting that calcification is irreversible and emphasizing the importance of prevention. Duration of pretransplant end-stage renal disease but not baseline calcification was a determinant of progression, consistent with cumulative, permanent changes to arteries that promote calcification.
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影响因子：
2.8
作者：
Crystal, P;Crystal, E;Strano, S
通讯作者：
Strano, S
DOI：
10.2215/cjn.06490711
发表时间：
2012-02-01
影响因子：
9.8
作者：
Abou Hassan, Nada;D'Orsi, Ellen T.;O'Neil, W. Charles
通讯作者：
O'Neil, W. Charles
影响因子：
6
作者：
Manzoor S;Ahmed S;Ali A;Han KH;Sechopoulos I;O'Neill A;Fei B;O'Neill WC
通讯作者：
O'Neill WC
DOI：
10.1161/atvbaha.119.313879
发表时间：
2020-05-01
影响因子：
8.7
作者：
Alappan, Harish R.;Kaur, Gurleen;O'Neill, W. Charles
通讯作者：
O'Neill, W. Charles
影响因子：
5.8
作者：
Evenepoel, P.;Goffin, E.;Jadoul, M.
通讯作者：
Jadoul, M.