Association of cause of uremia with degree of iliac artery calcification

OBJECTIVES: We aimed to investigate whether the cause of uremia is associated with degree of calcification, and to report the proportion excluded from kidney transplantation due to iliac artery calcification.

METHOD: We enrolled 306 patients with a pre-transplant computed tomography scan who went through the comprehensive assessment program in 2013-2015. Calcification score was measured for each iliac artery segment and patient records viewed for a variety of variables. Interobserver variation was assessed for 135 paired observations.

RESULTS: The patients' mean age was 55.5 years. Of the 306 patients, 133 did not undergo transplantation, and for 21 of these, heavy calcification was the primary explanation for this. External iliac artery calcification was positively associated with male sex, age, systolic blood pressure, diabetes and cardiovascular disease, and differed significantly among the causes of uremia subgroups; the least calcification was seen in patients with autoimmune causes, and the highest in those with diabetic causes. Similarly, the proportion of patients who underwent renal transplantation differed significantly with regard to causes of uremia (ranging from 72.3% for autoimmune disease to 40.6% for diabetic nephropathy).

CONCLUSION: The degree of iliac artery calcification differs according to the cause of uremia and influences the likelihood of receiving a kidney transplantation.