Association between blood pressure in the first-year post-kidney transplantation and pre-transplant coronary calcium scoring: a retrospective cohort study.

Background: End-stage kidney disease is often associated with calcification of the arteries, including the coronaries. Currently, it is unclear whether the coronary calcium score (CCS) correlates with blood pressure (BP) changes in kidney transplant recipients (KTRs). Methods: We retrospectively reviewed KTRs who followed up at our center for 12 months between 2017 and 2020. Data collected include demographics, baseline cardiovascular risk factors, pre-KTx cardiac work up, and the systolic (SBP) and diastolic BP (DBP) during the first year post-KTx. We divided patients in four categories based on their CCS and analyzed the above parameters accordingly. Results: 157 KTRs were included. There were 67 (42.6%) patients in the group with zero CCS, 42 (26.7%) in the 1-100 group, 21 (13.3%) in the 100-400 group, and 27 (17.1%) in the >400 group. KTRs with higher CCS were older, diabetics, with established coronary artery disease, and persistent hyperparathyroidism. KTRs with higher CCS had abnormal perfusion stress test, coronary angiogram, and greater calcification of the pelvic arteries. SBP trended down in the two groups with lower CCS and increased insignificantly in the higher groups. Additionally, DBP decreased in the groups with lower CCS, and no significant changes were noted in the group with CCS >400. Older age, high creatinine at 12 months, BP medications and CCS >400 were independently associated with SBP at 12 months. Conclusion: Severe CCS adversely affected the positive impact of KTx on the changes of SBP and DBP presumably due to arterial stiffness.