PT  - JOURNAL ARTICLE
AU  - Keyzer, Charlotte A.
AU  - de Borst, Martin H.
AU  - van den Berg, Else
AU  - Jahnen-Dechent, Willi
AU  - Arampatzis, Spyridon
AU  - Farese, Stefan
AU  - Bergmann, Ivo P.
AU  - Floege, Jürgen
AU  - Navis, Gerjan
AU  - Bakker, Stephan J.L.
AU  - van Goor, Harry
AU  - Eisenberger, Ute
AU  - Pasch, Andreas
TI  - Calcification Propensity and Survival among Renal Transplant Recipients
AID  - 10.1681/ASN.2014070670
DP  - 2016 Jan 01
TA  - Journal of the American Society of Nephrology
PG  - 239--248
VI  - 27
IP  - 1
4099  - http://jasn.asnjournals.org/content/27/1/239.short
4100  - http://jasn.asnjournals.org/content/27/1/239.full
SO  - J. Am. Soc. Nephrol.2016 Jan 01; 27
AB  - Calciprotein particle maturation time (T50) in serum is a novel measure of individual blood calcification propensity. To determine the clinical relevance of T50 in renal transplantation, baseline serum T50 was measured in a longitudinal cohort of 699 stable renal transplant recipients and the associations of T50 with mortality and graft failure were analyzed over a median follow-up of 3.1 years. Predictive value of T50 was assessed for patient survival with reference to traditional (Framingham) risk factors and the calcium-phosphate product. Serum magnesium, bicarbonate, albumin, and phosphate levels were the main determinants of T50, which was independent of renal function and dialysis vintage before transplant. During follow-up, 81 (12%) patients died, of which 38 (47%) died from cardiovascular causes. Furthermore, 45 (6%) patients developed graft failure. In fully adjusted models, lower T50 values were independently associated with increased all-cause mortality (hazard ratio, 1.43; 95% confidence interval, 1.11 to 1.85; P=0.006 per SD decrease) and increased cardiovascular mortality (hazard ratio, 1.55; 95% confidence interval, 1.04 to 2.29; P=0.03 per SD decrease). In addition to age, sex, and eGFR, T50 improved prognostication for all-cause mortality, whereas traditional risk factors or calcium-phosphate product did not. Lower T50 was also associated with increased graft failure risk. The associations of T50 with mortality and graft failure were confirmed in an independent replication cohort. In conclusion, reduced serum T50 was associated with increased risk of all-cause mortality, cardiovascular mortality, and graft failure and, of all tested parameters, displayed the strongest association with all-cause mortality in these transplant recipients.