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Int J Angiol 2017; 26(02): 102-108
DOI: 10.1055/s-0036-1593827
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Interaction of Serum Phosphate with Age as Predictors of Cardiovascular Risk Scores in Stable Renal Transplant Recipients

Jillian Kerry
1   College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
,
Holly Mansell
2   College of Pharmacy and and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
,
Hamdi Elmoselhi
3   Saskatchewan Transplant Program, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
,
Mike Moser
1   College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
3   Saskatchewan Transplant Program, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
,
Ahmed Shoker
3   Saskatchewan Transplant Program, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
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Publikationsdatum:
12. Dezember 2016 (online)

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Abstract

We calculated rate of changes in the cardiovascular risk calculator for renal transplant recipients (CRCRTR) major adverse cardiac events (MACE) in clinically stable renal transplant recipients (RTRs) to identify covariables that associate with fast cardiovascular (CV) risk progression. CRCRTR-MACE scores were calculated on 139 patients in 2011 and 2014. Score changes above and below median changes in scores were labeled fast or slow CV risk progression. Multivariate analysis (MVA) was performed to identify variables significant to percentage changes in scores. Receiver-operating characteristic (ROC) analysis was performed to define sensitivity and specificity of factors significant to fast score progression. Follow-up was 2.61 (2.02–4.47) years. Slow and fast progressions were present in 50.4 and 49.6% of patients, with a median change of 25.8% (− 92.1 to 1,444.7%). MVA showed percentage changes in age and serum phosphate were the only significant variables impacting fast progression in scores. ROC showed 2011 serum phosphate of 1.15 mmol/L to predict fast progression (area under the curve [AUC] of 0.628, p > 0.0126). Age older than 45 years combined with 2011 serum phosphate above 1.15 mmol/L had a significant AUC of 0.781, p < 0.0010 interleukin (IL)-1A and IL-28A were significant associates with serum phosphate above 1.1 mmol/L in the MVA. Changes in CV risk in RTR over time are highly variable. Serum phosphate, even within upper normal levels, predicts worsening of CV risk scores in stable RTR.

Keywords

renal function - cardiovascular risk factors - cardiovascular disease - glomerular filtration rate - renal transplant - cardiovascular risk calculator for renal transplant recipients - phosphorous