Background: Renal calcifications(RC) have been described in kidney transplantation(KTx), but the aetiology

and significance of this finding are still unclear. Our aim is to evaluate the prevalence an the clinical impact on long

term graft prognosis of RC.

Material and methods: 95 KTx pts,submitted to renal biopsy(RBx) on clinical indication from 2009 to 2012 were followed up

until 2016 (FU time:(5[4-6]yrs).Clinical and biochemical data were collected at the time of RBx(TBX),12mth before(T-

12) and after(T+12) the RBx. Exposition to Ca,P and PTH during the year before RBx was calculated by averages of

the observed values.In yrs after T+12(Tfu),creatinine,Ca,P,PTH,ALP,Prot-U were recorded annually and analyzed as

averages of observed values.

RBx were studied for general histology and for RC by Von Kossa(VK) staining. In pts with more than 1 RBx, only

the 1st one was considered. Pts in which VK was negative or slight positive were defined as group1(VK-1:n 68;46

slightly +), while pts with moderate or severe VK positivity were included in group2(VK-2:n=27;8 high VK

+).

Results: The pts were 51 males,age 50±12 yrs. VK groups did not differ for gender,age, type

of KTx, VK-2 had more time of KTx(p= 0.03). At T-12,TBX and T+12, renal function was similar between the groups.

No differences were found in mineral metabolism(MM) at TBX,while VK-2 had a lower exposition to PTH during the

year before RBx(p<0.001). VK-2 had higher glomerulosclerosis(GS;p=0.04). During Tfu,VK-2 pts had worst sCr(p=0.04) higher PTH and

ALP(p=0.03;p=0.002).

33 pts restarted dialysis during the FU time, with a higher prevalence in VK-2(p=0.0006). By means of Cox

and Kaplan Meier analysis belonging to VK-2 was the stronger independent factor related to graft loss

(HR=3.49–p=0.001;K-M p<0.0001).

Conclusion: The prevalence of RC in RBx is quite high. RC correlated with PTH exposition during the year

before RBx,but not with Ca and P levels.Time of KTx and GS also were related to RC,assigning to RC a significance

of chronic damage rather than a simply result of MM imbalance, at least in the RBX performed on clinical indication. A

relation between VK degree at TBX and long term graft loss was also found.

CITATION INFORMATION: Alfieri C., Moroni G., Cresseri D., Regalia A., Zanoni F., Binda V., Gandolfo M., Campise M., Meneghini M., Ikehata M., Messa P. Impact of Renal Parenchymal Calcifications in a Cohort of Renal Transplanted Patients and Their Correlations with Long Term Graft Outcome Am J Transplant. 2017;17 (suppl 3).

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