Ghanem, Roaa

ABSTRACT Background Abdominal arterial calcification (AAC) is a common comorbidity in patients with end‐stage kidney disease (ESKD) and a predictor of cardiovascular events post‐kidney transplant. However, prior studies lacked a standardized approach to evaluate AAC and its impact on post‐transplant outcomes. This study aimed to correlate AAC score values with post‐kidney transplant outcomes using a modified scoring system traditionally applied to coronary artery calcification. Methods This retrospective study included 14 339 adult patients listed for kidney transplant between 2002 and 2023 at three transplant centers. Among them, 3683 patients met the criteria of undergoing a kidney transplant and an abdominal computed tomography (CT) scan pre‐transplant. We modified the coronary calcium score software by adjusting intake data points to quantify calcification in the abdominal aorta, common iliac, external iliac, and internal iliac arteries. Outcomes focused on post‐transplant mortality. Results In 3683 kidney transplant recipients, higher AAC scores were significantly associated with increased mortality. Each 1000‐unit increase in AAC score elevated hazard ratios (HRs) across arterial regions, including 1.116 for the aorta and 1.389 for the internal iliac (all p < 0.001). Adjusted analyses confirmed AAC as an independent risk factor for mortality. Kaplan–Meier curves demonstrated lower survival with increasing AAC quartiles. Conclusions AAC, measured by a standardized score, is a significant mortality risk factor in kidney transplant recipients. Integrating AAC scores into pre‐transplant evaluations could enhance risk stratification and improve outcomes. Prospective studies are needed to validate these findings and explore interventions to reduce AAC and improve survival.

ABSTRACTUreteral stenosis is a frequent complication after kidney transplantation, causing significant morbidity and potential graft function impairment. Treatment options include conservative management, endourological procedures, surgical interventions and percutaneous nephrostomy (PCN). While PCN effectively relieves obstruction, it comes with its own complications. This study evaluates the risk factors, incidence, complications and outcomes of PCN in this population.We conducted a retrospective case series analysis of 98 kidney transplant recipients who underwent PCN. Data on demographics, clinical characteristics and procedural outcomes were collected and analysed to assess the incidence of complications and identify associated risk factors.Among the 98 recipients, the median age at transplant was 56 years, with 52% being male. The most common comorbidities included hypertension (75.5%) and diabetes mellitus (35.7%). Complications occurred in 38.8% of patients, with infections being the most frequent (74.4%), including urinary tract infections (28.9%) and pyelonephritis (22.4%). The primary organisms identified were gram‐negative bacteria (55.1%). Reconstructive surgery was required in 35.7% of cases and patient survival was 83.7% at follow‐up.In conclusion, PCN in kidney transplant recipients is associated with a high rate of complications, particularly infections. Effective management necessitates the identification and addressing of associated risk factors such as diabetes, elevated BMI and specific induction therapies. While PCN is vital for preserving graft function, further research should focus on refining clinical protocols and developing targeted preventive strategies for high‐risk patients.