Renal allograft calcification -- prevalence and etiology in pediatric patients

Am J Nephrol. 2009;30(3):194-200. doi: 10.1159/000217585. Epub 2009 Apr 30.

Abstract

Background: Calcification of renal allografts has been reported in adult kidney transplant (KTx) recipients with a widely differing prevalence (2-60%). Persistent hyperparathyroidism, hypercalcemia and concomitant hypercalciuria were identified as major risk factors. We aimed to determine the prevalence and risk factors for such calcifications in children.

Methods: We investigated histological stains of routine graft biopsies from pediatric KTx patients for renal calcifications and determined the urinary excretion of lithogenic (oxalate, calcium) and stone-inhibitory substances (citrate).

Results: In our series of transplant patients, tubular calcification was found in 16 of the 36 (44.4%) KTx biopsies by an additional Kossa stain. This transplant calcification was not associated with any singular risk factor and was not correlated to a worse transplant outcome.

Conclusion: Although our pediatric findings confirm the reported incidence rates of KTx calcification in adults, we could neither identify hypercalciuria as a risk factor nor confirm any negative influence on graft function. However, long-term studies are clearly needed to prove or disprove a negative impact of calcifications on graft function.

MeSH terms

  • Adolescent
  • Child
  • Female
  • Humans
  • Kidney Transplantation*
  • Male
  • Nephrocalcinosis / diagnosis
  • Nephrocalcinosis / epidemiology*
  • Nephrocalcinosis / etiology*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology*
  • Prevalence
  • Young Adult