Comparison of single CT scan assessment of bone mineral density, vascular calcification and fat mass with standard clinical measurements in renal transplant subjects: the ABC HeART studyReport as inadecuate




Comparison of single CT scan assessment of bone mineral density, vascular calcification and fat mass with standard clinical measurements in renal transplant subjects: the ABC HeART study - Download this document for free, or read online. Document in PDF available to download.

BMC Nephrology

, 16:188

First Online: 11 November 2015Received: 02 March 2015Accepted: 02 November 2015

Abstract

BackgroundDespite limitations of routine methods, Clinical Practice Guidelines support the assessment of bone mineral density BMD and vascular calcification in renal transplant recipients. Changes in fat mass also occur post-transplantation, although they are traditionally difficult to measure accurately. We report the feasibility, convenience and accuracy of measuring the above 3 parameters using a novel CT protocol.

MethodsWe conducted a cross-sectional study of 64 first renal allograft recipients eGFR > 30 ml-min-1.73 m. Quantitative CT QCT BMD analysis was conducted using CT lumbar spine GE Medical Systems Lightspeed VCT and Mindways QCT Pro Bone Mineral Densitometry System Version 4.2.3 to calculate spinal volumetric BMD and compared with standard DXA calculated areal BMD at the spine, hip and distal forearm. Abdominal aortic calcification was assessed by semi-quantitative Aortic Calcification Index ACI method and compared with lateral lumbar x-ray Kappuila score and pulse wave velocity PWV. Visceral and subcutaneous adipose tissue volume Osirix 16 Ver 3.7.1 was compared with BMI.

ResultsParticipants were 61 % male, had a mean age of 47 years, median ESKD duration of 5.4 years and a mean eGFR of 54 ml-min. iDXA median T-score at proximal femur was −1.2 and at lumbar spine was −0.2. Median QCT Trabecular T-score at lumbar spine was −1.2. The percent of subjects with a T-score of <2.5 by site and method was DXA Proximal Femur: 7 %, DXA distal radius: 17 %, DXA spine: 9 %, QCT American College of Radiology cutoffs: 9 %. CT derived ACI correlated with PWV r = 0.29, p = 0.02, pulse wave pressure r = 0.51, p < 0.001, QCT Trabecular −0.31, p = 0.01 and cortical volumetric BMD and history of cardiovascular events Mann–Whitney U, p = 0.02. Both visceral and subcutaneous adipose tissue correlated with BMI r = 0.63 and 0.64, p < 0.001.

ConclusionsSingle CT scan triple assessment of BMD, vascular calcification and body composition is an efficient, accurate and convenient method of risk factor monitoring post renal transplantation.

KeywordsRenal transplantation Bone mineral density Vascular calcification Adiposity Cardiovascular disease Risk factors AbbreviationsACIAortic calcification index

APAnteroposterior

BMDBone mineral density

BMIBody mass index

CKDChronic kidney disease

CTComputed tomography

DXADual energy X-ray absorptiometry

EBCTElectron beam computed tomography

ESKDEnd stage kidney disease

HDLHigh density lipoprotein

KDIGOKidney disease improving global outcomes

LDLLow density lipoprotein

mSvmilliSievert

NODATNew onset diabetes after transplantation

pQCTPeripheral quantitative computed tomography

PWVPulse wave velocity

QCTQuantitative computed tomography

SATSubcutaneous adipose tissue

SPSSStatistical package for the social sciences

VATVisceral adipose tissue

Download fulltext PDF



Author: Sinead Kinsella - Kevin Murphy - Micheal Breen - Siobhan O’Neill - Patrick McLaughlin - Joe Coyle - Conor Bogue - Fiona 

Source: https://link.springer.com/







Related documents