Calcification Propensity (T50) Predicts a Rapid Decline of Renal Function in Kidney Transplant Recipients

• Published in: Journal of clinical medicine Vol. 12; no. 12; p. 3965
• Main Authors: Hammer, Nathalie, Legouis, David, Pasch, Andreas, Huber, Aurélie, Al-Qusairi, Lama, Martin, Pierre-Yves, de Seigneux, Sophie, Berchtold, Lena
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.06.2023; MDPI
• Subjects: Biomarkers; Calcification; Care and treatment; Chronic kidney failure; Clinical medicine; Complications and side effects; Creatinine; decline of renal function; Health aspects; Kidney diseases; kidney transplant; Kidney transplants; Kidneys; Laboratories; Medical prognosis; Metabolism; Mortality; Organ transplant recipients; Patients; phosphocalcic markers; prediction; Prognosis; Serodiagnosis; Transplantation; Variables; Switzerland; kidney transplant; prediction; phosphocalcic markers; decline of renal function
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12123965

Serum creatinine level, proteinuria, and interstitial fibrosis are predictive of renal prognosis. Fractional excretion of phosphate (FEP)/FGF23 ratio, tubular reabsorption of phosphate (TRP), serum calcification propensity (T50), and Klotho's serum level are emerging as determinants of poor kidney outcomes in CKD patients. We aimed at analysing the use of FGF23, FEP/FGF23, TRP, T50, and Klotho in predicting the rapid decline of renal function in kidney allograft recipients. We included 103 kidney allograft recipients in a retrospective study with a prospective follow-up of 4 years. We analysed the predictive values of FGF23, FEP/FGF23, TRP, T50, and Klotho for a rapid decline of renal function defined as a drop of eGFR > 30%. During a follow-up of 4 years, 23 patients displayed a rapid decline of renal function. Tertile of FGF23 ( value = 0.17), FEP/FGF23 ( value = 0.78), TRP ( value = 0.62) and Klotho ( value = 0.31) were not associated with an increased risk of rapid decline of renal function in kidney transplant recipients. The lower tertile of T50 was significantly associated with eGFR decline >30% with a hazard ratio of 3.86 ( = 0.048) and remained significant in multivariable analysis. T50 showed a strong association with a rapid decline of renal function in kidney allograft patients. This study underlines its role as an independent biomarker of loss of kidney function. We found no association between other phosphocalcic markers, such as FGF23, FEP/FGF23, TRP and Klotho, with a rapid decline of renal function in kidney allograft recipients.