Calcification Propensity (T50) Predicts a Rapid Decline of Renal Function in Kidney Transplant Recipients
Abstract
:1. Introduction
2. Material and Methods
2.1. Statistical Analysis
2.2. Outcomes
3. Results
3.1. Characteristics of the Study Population
3.2. Association between Phosphocalcic Biomarkers and Renal Function at Baseline
3.3. Univariable and Multivariable Analysis of Predictors of Renal Function Decline
3.4. Multivariable Analysis of Predictors of Renal Function Decline
4. Discussion
5. Conclusions
6. Three Statements
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total (n = 103) | eGFR Decline at 4 Years ≤ 30% (n = 80) | eGFR Decline at 4 Years > 30% (n = 23) | p Value | |
---|---|---|---|---|
Characteristics | - | |||
Age, years | 56 ± 14 | 56 ± 14 | 57 ± 13 | 0.57 |
Male, n (%) | 63 (61.2) | 48 (60) | 15 (65.2) | 0.65 |
Caucasian, n (%) | 98 (95.2) | 76 (95) | 22 (95.7) | 0.89 |
Clinical parameters | ||||
Systolic blood pressure (mmHg) *a | 132 ± 16 | 132 ± 15 | 131 ± 20 | 0.76 |
Diastolic blood pressure (mmHg) *a | 80 ± 12 | 80 ± 12 | 78 ± 12 | 0.44 |
BMI (kg/m2) | 25.3 ± 4.3 | 25.4 ± 4.3 | 24.8 ± 4.4 | 0.57 |
Dialysis before tx, n (%) *c | 40 (72.7) | 31 (73.8) | 9 (69.2) | 0.75 |
Dialysis duration, mths, *c | 24.2 ± 29.4 | 24.45 ± 30.8 | 23.3 ± 25.6 | 0.90 |
Donor age, years, *c | 53 ± 14 | 54 ± 14 | 54 ± 15 | 0.94 |
Living donor transplant, n (%) | 40 (38.8) | 32 (40) | 8 (34.8) | 0.65 |
Graft vintage (year) | 9.48 ± 7.3 | 9.45 ± 7.1 | 9.6 ± 8.2 | 0.94 |
2nd or 3rd transplant, n (%) | 14 (13.6) | 11 (13.8) | 3 (13) | 0.93 |
Rejection episodes, n (%) | 46 (44.7) | 32 (40) | 14 (60.9) | 0.08 |
Infections, n (%) | 52 (66.7) | 40 (66.7) | 12 (66.7) | 1 |
Opportunistic inf, n (%) *c | 0.76 | |||
None | 41 (51.3) | 30 (49.2) | 11 (57.9) | |
1 | 31 (38.8) | 25 (41) | 6 (31.6) | |
2 | 8 (10) | 6 (9.8) | 2 (10.5) | |
NODAT, n (%) | 11 (10.7) | 9 (11.3) | 2 (8.7) | 0.73 |
Etiology of kidney disease, n (%) | ||||
Diabetes | 4 (3.9) | 3 (3.8) | 1 (4.4) | 0.89 |
Hypertension | 20 (19.4) | 13 (16.3) | 7 (30.4) | 0.13 |
Glomerulonephritis | 22 (21.4) | 18 (22.5) | 4 (17.4) | 0.6 |
Polycystic kidney disease | 20 (19.4) | 15 (18.8) | 5 (21.7) | 0.75 |
Others (tubulo-interstitial nephritis…) | 41 (39.8) | 34 (42.5) | 7 (30.4) | 0.3 |
Treatment, n (%) | ||||
CNI | 92 (89.3) | 77 (87.5) | 22 (95.7) | 0.27 |
Mycophenolate mofetil | 80 (77.7) | 61 (76.3) | 19 (82.6) | 0.52 |
Corticostéroids | 60 (58.3) | 43 (53.8) | 17 (73.9) | 0.08 |
ACE-I/ARB | 54 (52.4) | 39 (48.8) | 15 (65.2) | 0.16 |
Calcium channel blockers | 50 (48.5) | 37 (46.3) | 13 (56.5) | 0.39 |
Diuretics | 7 (6.8) | 4 (5) | 3 (13) | 0.18 |
Beta-blockers | 56 (54.4) | 44 (55) | 12 (52.2) | 0.81 |
Calcium | 69 (67) | 54 (67.5) | 15 (65.2) | 0.84 |
Vitamine D | 88 (85.4) | 68 (85) | 20 (87) | 0.82 |
Laboratory | ||||
eGFR at baseline (mL/min/1.73 m2) | 55.6 ± 18.6 | 56 ± 18.4 | 54.4 ± 19.9 | 0.72 |
eGFR at 4 years (mL/min/1.73 m2) | 48.3 ± 19.7 | 53.9 ± 16.9 | 28.8 ± 16.1 | <0.001 |
Proteinuria (g/d) *b | 0.4 ± 1.4 | 0.4 ± 1.6 | 0.2 ± 0.2 | 0.5 |
Alb/Creat ratio (mg/d) *b | 148.8 ± 283 | 116.5 ± 272.1 | 255.6 ± 298 | 0.04 |
Hemoglobine (g/L) | 129 ± 14 | 129.8 ± 13.4 | 126.4 ± 15.9 | 0.31 |
Calcium (mmol/L) | 2.41 ± 0.14 | 2.41 ± 0.13 | 2.42 ± 0.17 | 0.9 |
Phosphate (mmol/L) | 1.09 ± 0.23 | 1.07 ± 0.2 | 1.13 ± 0.32 | 0.32 |
Vitamine D (nmol/L) *a | 68.6 ± 21.6 | 68.7 ± 21.6 | 68.3 ± 22.1 | 0.94 |
Parathormone (pmol/L) *a | 9.14 ± 4.6 | 8.8 ± 4.1 | 10.1 ± 6.1 | 0.25 |
Bicarbonate (mmol/L) *a | 24.3 ± 3.4 | 24.3 ± 3.6 | 24.3 ±2.6 | 0.99 |
Albumin (g/L) | 37.4 ± 3.6 | 37.7 ± 3.6 | 36.5 ± 3.4 | 0.18 |
FEP/FGF23 § ratio *b | 0.72 ± 0.39 | 0.73 ± 0.4 | 0.7 ± 0.4 | 0.77 |
FEP (%) | 26.2 ± 11.1 | 25.9 ± 10.3 | 27.1 ± 13.5 | 0.68 |
FGF23 (pg/mL) | 43.6 ± 28.7 | 43.2 ± 29.7 | 45.2 ± 25.5 | 0.77 |
TRP ‡,*b | 0.98 ± 0.01 | 0.98 ± 0 | 0.98 ± 0.01 | 0.68 |
TmP/GFR ¶ (mmol/L) *b | 1.48 ± 0.3 | 1.45 ± 0.3 | 1.58 ± 0.5 | 0.12 |
Klotho (pg/mL) | 734.9 ± 244.2 | 751.6 ±264 | 676.6 ± 147.4 | 0.2 |
T50 (min) | 285.2 ± 56.7 | 291.9 ± 55.9 | 262 ± 54.6 | 0.03 |
HR | 95% CI | p Value | |
---|---|---|---|
Tertile Klotho | |||
First tertile | Reference | ||
Second tertile | 1.41 | 0.56–3.58 | 0.47 |
Third tertile | 0.63 | 0.21–1.92 | 0.42 |
Tertile FGF23 | |||
First tertile | Reference | ||
Second tertile | 2.65 | 0.92–7.64 | 0.07 |
Third tertile | 1.72 | 0.55–5.42 | 0.35 |
Tertile FEP | |||
First tertile | Reference | ||
Second tertile | 1.52 | 0.54–4.28 | 0.43 |
Third tertile | 0.97 | 0.31–3.02 | 0.96 |
Tertile FEP/FGF23 | |||
First tertile | Reference | ||
Second tertile | 0.72 | 0.25–2.08 | 0.54 |
Third tertile | 1.01 | 0.37–2.8 | 0.98 |
Tertile T50 | |||
Third tertile | Reference | ||
Second tertile | 2.78 | 0.74–10.48 | 0.13 |
First tertile | 4.26 | 1.2–15.09 | 0.025 |
Tertile TRP | |||
First tertile | Reference | ||
Second tertile | 1.56 | 0.56–4.4 | 0.4 |
Third tertile | 1.03 | 0.33–3.19 | 0.96 |
Tertile TmP/GFR | |||
Third tertile | Reference | ||
Second tertile | 2.29 | 0.69–7.62 | 0.18 |
First tertile | 2.53 | 0.78–8.22 | 0.12 |
HR | 95% CI | p Value | |
---|---|---|---|
eGFR | |||
≥45 & <60 mL/min/1.73 m2 | 0.27 | 0.05–1.51 | 0.14 |
<45 & ≥30 mL/min /1.73 m2 | 0.28 | 0.06–1.33 | 0.11 |
<30 mL/min/1.73 m2 | 0.1 | 0.01–0.97 | 0.047 |
Albuminuria | |||
30–300 mg/24 h | 1.89 | 0.65–5.48 | 0.24 |
>300 mg/24 h | 4.47 | 1.39–14.52 | 0.012 |
Tertile T50 | |||
Second tertile | 2.5 | 0.62–10.01 | 0.2 |
First tertile | 3.86 | 1.01–14.7 | 0.048 |
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Hammer, N.; Legouis, D.; Pasch, A.; Huber, A.; Al-Qusairi, L.; Martin, P.-Y.; de Seigneux, S.; Berchtold, L. Calcification Propensity (T50) Predicts a Rapid Decline of Renal Function in Kidney Transplant Recipients. J. Clin. Med. 2023, 12, 3965. https://doi.org/10.3390/jcm12123965
Hammer N, Legouis D, Pasch A, Huber A, Al-Qusairi L, Martin P-Y, de Seigneux S, Berchtold L. Calcification Propensity (T50) Predicts a Rapid Decline of Renal Function in Kidney Transplant Recipients. Journal of Clinical Medicine. 2023; 12(12):3965. https://doi.org/10.3390/jcm12123965
Chicago/Turabian StyleHammer, Nathalie, David Legouis, Andreas Pasch, Aurélie Huber, Lama Al-Qusairi, Pierre-Yves Martin, Sophie de Seigneux, and Lena Berchtold. 2023. "Calcification Propensity (T50) Predicts a Rapid Decline of Renal Function in Kidney Transplant Recipients" Journal of Clinical Medicine 12, no. 12: 3965. https://doi.org/10.3390/jcm12123965