Prevalence of, and factors correlated with, vascular calcification and vascular stiffness in kidney transplant patients

Cardiovascular disease remains the leading cause of mortality among patients with kidney failure, including kidney transplant recipients. Chronic kidney disease–mineral and bone disorder (CKD-MBD) contributes to vascular injury through disordered mineral metabolism and uremic toxicity.1 Although kidney transplantation improves kidney function, vascular abnormalities may persist due to residual metabolic disturbances, prior dialysis exposure, and immunosuppressive therapy.2 Vascular calcification reflects structural vascular damage, whereas vascular stiffness represents functional arterial impairment and is independently associated with adverse cardiovascular outcomes, including left ventricular hypertrophy, heart failure, and all-cause mortality.3 However, data on the burden and determinants of these vascular abnormalities in kidney transplant recipients remain limited. This study aimed to assess the prevalence of vascular calcification, evaluated by lateral abdominal plain radiography, and vascular stiffness, measured using the cardio-ankle vascular index , and to identify associated clinical and biochemical factors among kidney transplant recipients. Details are provided in the Supplementary Methods. A total of 392 kidney transplant recipients were included. The mean age was 51.6 ± 12.4 years, and 43% were female. The median serum creatinine was 1.3 mg/dL (interquartile range [IQR] 1.0–1.6). The median dialysis vintage was 36 months (17–61), and the median duration since kidney transplantation was 74 months (40–133). Baseline characteristics are shown in Table S1.