Lewis JR, et al. - Whether abdominal aortic calcification (AAC) assessed by lateral spine x-rays and the Kaupilla 24-point AAC (0–24) score may detect higher cardiovascular (CV) risk in kidney and pancreas-kidney (SPK) transplant recipients, was investigated. Participants were 413 kidney and 213 SPK first transplant recipients. At the time of transplant, these were scored for AAC and then observed for CV events (coronary heart, cerebrovascular, or peripheral vascular disease), graft-loss, and all-cause mortality. Findings revealed the presence of 3-fold higher CV and death risk and poorer graft outcomes among kidney and SPK transplant recipients with high AAC vs recipients without AAC. The possible utility of AAC scoring in evaluating and targeted risk-lowering strategies was suggested in this study.