*5.1.3 PTMBD: vascular calcifications*

VC is common after KT and is usually associated with pre-transplant uremia. In addition, most studies are semi-quantitative, thus making post-transplant VC progression assessment difficult. However, there are studies demonstrating a stop in progression or even improvement in VC in KTRs [83, 84]. Recognized risk factors for VC after KT are statin use, low 25VD levels, male sex, older age, and higher phosphate levels [85]. The data for the effect of immunosuppressive agents are conflicting. Mycophenolates proved to have protective effects against calcification, especially compared to steroids and calcineurin inhibitors; rapamycin suppressed smooth muscle cell proliferation, whereas everolimus impaired the vasoactive and antithrombotic function of the endothelium [86]. Therefore, more studies are needed in order to evaluate the effect of KT on VC.
