Impact of Pelvic Calcification Severity on Renal Transplant Outcomes: A Prospective Single-Center Study

Žuža, Iva; Dodig, Doris; Brumini, Ivan; Kutlić, Mate; Đurić, Robert; Katalinić, Nataša; Gršković, Antun; Jakšić, Ante; Mavrinac, Martina; Ćelić, Tanja; Rački, Sanjin; Orlić, Lidija; Nekić, Jasna; Markić, Dean

doi:10.3390/jcm13206171

Open AccessArticle

Impact of Pelvic Calcification Severity on Renal Transplant Outcomes: A Prospective Single-Center Study

by

Iva Žuža

^1,*,†

,

Doris Dodig

²

,

Ivan Brumini

¹

,

Mate Kutlić

³,

Robert Đurić

³,

Nataša Katalinić

^3,4

,

Antun Gršković

^3,5

,

Ante Jakšić

^3,5,

Martina Mavrinac

⁶,

Tanja Ćelić

³,

Sanjin Rački

^3,7,

Lidija Orlić

^3,7,

Jasna Nekić

⁸ and

Dean Markić

^3,5,†

¹

Department of Diagnostic and Interventional Radiology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia

²

European Telemedicine Clinic, 08005 Barcelona, Spain

³

Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia

⁴

Clinical Institute of Transfusion Medicine, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia

⁵

Department of Urology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia

⁶

Faculty of Educational Sciences, University of Pula, 52100 Pula, Croatia

⁷

Department of Nephrology, Dialysis and Transplantation, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia

⁸

Department of Nuclear Medicine, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

J. Clin. Med. 2024, 13(20), 6171; https://doi.org/10.3390/jcm13206171

Submission received: 21 August 2024 / Revised: 13 October 2024 / Accepted: 14 October 2024 / Published: 16 October 2024

(This article belongs to the Special Issue Kidney Failure: Diagnosis and Treatment of Acute and Chronic Conditions)

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Abstract

Background: Vascular calcifications (VC) are increasingly prevalent in patients with chronic kidney disease. This study aimed to assess the incidence of iliac artery calcifications in kidney transplant (KT) patients and explore the relationship between iliac VC burden measured by pelvic calcification score (PCS) and renal transplant outcomes. Methods: This prospective study involved 79 KT recipients. VC quantification, using a pre-transplant computed tomography (CT) scan, was performed by assessing calcifications in the common and external iliac arteries bilaterally, resulting in an overall PCS ranging from 0 (no calcifications) to 44 (extensive calcifications). Based on PCS values, patients were divided into three equal-sized groups: PCS Group 1 (PCS 0–4), PCS Group 2 (PCS 5–19), and PCS Group 3 (PCS > 19). Post-transplant outcomes tracked for at least 1 year were patient and graft survival, graft function (urea, creatinine, MAG-3 clearance), and incidence of MACE during the first post-transplant year. Results: Calcifications were present in at least one arterial segment in 61 patients (77.2%). One-year patient survival was 95%, and one-year graft survival was 92.4%. Patients in PCS Group 3 had significantly lower one-year patient and graft survival compared to those in PCS Group 1 and 2 (p = 0.006 and p = 0.008, respectively). MACE and renal function indicators 1-year post-transplant were similar across all PCS groups. Conclusions: Our study demonstrated that a significant majority of KT recipients exhibited iliac VC during pre-transplant CT assessments. Patients in PCS Group 3 exhibited significantly lower one-year patient and graft survival rates compared to those in PCS Groups 1 and 2, indicating that this subgroup may require more intensive post-transplant monitoring and management.

Keywords: kidney transplantation; kidney transplant outcomes; tomography; spiral computed; vascular calcification

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MDPI and ACS Style

Žuža, I.; Dodig, D.; Brumini, I.; Kutlić, M.; Đurić, R.; Katalinić, N.; Gršković, A.; Jakšić, A.; Mavrinac, M.; Ćelić, T.; et al. Impact of Pelvic Calcification Severity on Renal Transplant Outcomes: A Prospective Single-Center Study. J. Clin. Med. 2024, 13, 6171. https://doi.org/10.3390/jcm13206171

AMA Style

Žuža I, Dodig D, Brumini I, Kutlić M, Đurić R, Katalinić N, Gršković A, Jakšić A, Mavrinac M, Ćelić T, et al. Impact of Pelvic Calcification Severity on Renal Transplant Outcomes: A Prospective Single-Center Study. Journal of Clinical Medicine. 2024; 13(20):6171. https://doi.org/10.3390/jcm13206171

Chicago/Turabian Style

Žuža, Iva, Doris Dodig, Ivan Brumini, Mate Kutlić, Robert Đurić, Nataša Katalinić, Antun Gršković, Ante Jakšić, Martina Mavrinac, Tanja Ćelić, and et al. 2024. "Impact of Pelvic Calcification Severity on Renal Transplant Outcomes: A Prospective Single-Center Study" Journal of Clinical Medicine 13, no. 20: 6171. https://doi.org/10.3390/jcm13206171

APA Style

Žuža, I., Dodig, D., Brumini, I., Kutlić, M., Đurić, R., Katalinić, N., Gršković, A., Jakšić, A., Mavrinac, M., Ćelić, T., Rački, S., Orlić, L., Nekić, J., & Markić, D. (2024). Impact of Pelvic Calcification Severity on Renal Transplant Outcomes: A Prospective Single-Center Study. Journal of Clinical Medicine, 13(20), 6171. https://doi.org/10.3390/jcm13206171

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Impact of Pelvic Calcification Severity on Renal Transplant Outcomes: A Prospective Single-Center Study

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