POS-746 PRE-KIDNEY TRANSPLANT MEDIAL ARTERIAL CALCIFICATION AND POST-TRANSPLANT HYPERTENSION BY A PROPENSITY SCORE WEIGHTING

Introduction: Medial arterial calcification (MAC) detected in the breast by mammography (MG) is exclusively medial and associated with cardiovascular mortality in end-stage renal disease (ESRD). This association is unclear in renal transplant recipients (RTR). Hypothesis: By comparing groups of study population balanced by propensity score weighting method, MAC is associated with an increased risk of post-transplant mortality. Methods: Female RTR was divided into 2 groups per presence or absence of pre-transplant MAC examined from MG (MAC and non-MAC), and both groups was balanced with by PS weighting leading to a new study population. Association between MAC and post-transplant mortality of the new study population was examined by multi-variable logistic regression analysis. Results: Of 51 patients, mean age±SD was 57.08±10.47 years old. The majority were white (54.9%) followed by African American (35.3%) and others (9.8%). Incidence rate of mortality was 0.0307 person-years. Median time to follow-up was 3.95 years (range 0.22 to 6.37). Among 20 patients in MAC group, 5 patients died; whereas, only 1 out of 31 patients in non-MAC died (25% vs. 3.23%, p 0.029). Baseline characteristics of both groups were not equal. After using PS weights with generalized boosted modeling, new study population’s characteristics were balanced (Figure 1). MAC is associated with 5.97 times higer the odd of morality compared to non-MAC, but the association was not significant (OR 5.97; 95%CI 0.61, 58.77). After adjusted for age, race, causes of ESRD, dialysis modality, dialysis vintage, donor type, donor age, and type of immunosuppressive medications, the magnitude of the association was increased and becomes significant (OR 38.40; 95%CI 2.44, 604.54). Conclusions: Similar to ESRD, MAC remains associated with higher mortality in RTR and this association is confirmed by well-matched study population. Prevention of pre-transplant MAC should be pursued to mitigate poor post-transplant outcomes.

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Pretransplant Hypoalbuminemia As A Predictor of Medical Arterial Calcification During Waiting List Pre‐Kidney Transplant Period: A Propensity Score Weighting Analysis

The FASEB Journal ◽

10.1096/fasebj.2020.34.s1.07412 ◽

2020 ◽

Vol 34 (S1) ◽

pp. 1-1

Author(s):

Ekamol Tantisattamo ◽

Natnicha Leelaviwat ◽

Chawit Lopimpisuth ◽

Sakditad Saowapa ◽

Natchaya Polpichai ◽

...

Keyword(s):

Propensity Score ◽

Kidney Transplant ◽

Waiting List ◽

Arterial Calcification ◽

Propensity Score Weighting

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366 Peritoneal Dialysis as a Predictor of Pre-Transplant Medical Arterial Calcification in Waitlist Kidney Transplant Candidates: A Propensity Score Weighting Analysis

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2020.02.368 ◽

2020 ◽

Vol 75 (4) ◽

pp. 643

Keyword(s):

Peritoneal Dialysis ◽

Propensity Score ◽

Kidney Transplant ◽

Arterial Calcification ◽

Propensity Score Weighting ◽

Transplant Candidates

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286 Dialysis Modality and Hypertension at an Early Post-Kidney Transplant Period: A Propensity Score Weighting

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2021.02.291 ◽

2021 ◽

Vol 77 (4) ◽

pp. 657

Keyword(s):

Propensity Score ◽

Kidney Transplant ◽

Dialysis Modality ◽

Propensity Score Weighting

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Abstract 13571: Association Between Pre-kidney Transplantation Medial Arterial Calcification Andpost-transplant Visit-to-visit Blood Pressure Variability: A Propensity Score Matching Analysis

Circulation ◽

10.1161/circ.142.suppl_3.13571 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Ekamol Tantisattamo ◽

Sakditad Saowapa ◽

Natnicha Leelaviwat ◽

Busara Songtanin ◽

Chawit Lopimpisuth ◽

...

Keyword(s):

Blood Pressure ◽

Propensity Score ◽

Propensity Score Matching ◽

Blood Pressure Variability ◽

Mineral Metabolism ◽

Statistical Significance ◽

Mean Difference ◽

Absolute Difference ◽

Arterial Calcification ◽

Medial Arterial Calcification

Introduction: Arterial calcification is associated with vascular stiffness, which manifests with visit-to-visit blood pressure variability (VVBPV). Although media arterial calcification (MAC) is significantly associated with poor cardiovascular outcomes in kidney patients, the association in kidney transplant (KT) patients is unknown. Hypothesis: We hypothesize that MAC is associated with VVBPV in long-tern post-KT. Methods: Since MAC, which is detected from mammogram (MG) and determined by linear calcified breast arteries, is exclusively medial, female KT patients with ≥1 MG during pre-KT period were included in this study. VVBPV was examined by average successive variability (ASV), which is the average absolute difference between successive BP measured at 4, 12, 24, 36, and 48 weeks post-KT. After balancing patients with and without MAC by using propensity score matching based on age, diabetes, and obesity status, the association between MAC and systolic and diastolic VVBPV (VVSBPV and VVDBPV) at 48 weeks post-KT was tested by multiple linear regression (Figure1A&1B). Results: Of 51 patients, mean age±SD is 54±12 years, 21 had diabetes, and 21 were obese. Mean duration of follow-up was 47±9 years. Among 20 patients with MAC, mean VVSBPV was 20±14 mmHg; whereas, VVSBPV in non-MG group was 14±8 mmHg (mean difference -6± 3.0, p 0.06, 95%CI -12.03, 0.15). Mean VVDBPV in MG and non-MG groups were 12±5 and 11±5.6 mmHg, respectively (mean difference -1±1.6, p 0.41, 95%CI -4.44, 1.86). Laboratory-related bone and mineral metabolism were not different between both groups. On average, MG group had 8 mmHg higher VVSBPV compared to non-MG group (Coef. 3.62, p 0.02, 95%CI 1.16, 15.34). The MG group remained having higher VVDBPV but the magnitude of the association decreased and no statistical significance (Coef. 0.58, p 0.83, 95%CI -4.58, 5.73). Conclusions: Similar to non-transplant patients, KT recipients with pre-KT MAC had significant higher VVSBPV at the late post-KT.

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