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Incidence and Risk Factors of Persistent Hyperparathyroidism After Kidney Transplantation.
Nakai, K; Fujii, H; Ishimura, T; Fujisawa, M; Nishi, S.
Afiliación
  • Nakai K; Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Nephrology and Kidney Center, Kakogawa East City Hospital, Kakogawa, Japan.
  • Fujii H; Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Ishimura T; Department of Organs Therapeutics, Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Fujisawa M; Department of Organs Therapeutics, Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Nishi S; Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: snishi@med.kobe-u.ac.jp.
Transplant Proc ; 49(1): 53-56, 2017.
Article en En | MEDLINE | ID: mdl-28104158
Persistent hyperparathyroidism after kidney transplantation is related to graft function, but pre-transplantation risk factors of persistent hyperparathyroidism have not been evaluated in detail. We enrolled 86 patients who had undergone kidney transplantation between 2008 and 2014. Nine patients showed persistent hyperparathyroidism characterized by the following: 1) serum parathyroid hormone levels >65 pg/mL and serum calcium levels >10.5 mg/dL at 1 year after kidney transplantation; 2) parathyroidectomy after kidney transplantation; and 3) reintroduction of cinacalcet after kidney transplantation. Compared with other patients, these 9 patients had significantly longer duration of dialysis therapy (186 ± 74 mo vs 57 ± 78 mo) and more frequent treatment with cinacalcet during dialysis (89% vs 12%). Multivariate analysis showed that dialysis vintage, calcium phosphate products, and cinacalcet use before kidney transplantation were independent risk factors of persistent hyperparathyroidism after kidney transplantation. A receiver operating characteristic curve showed 72 months as the cutoff value of dialysis vintage and 55 as the cutoff value of calcium phosphate products. In conclusion, dialysis vintage >6 years, calcium phosphate products >55 (mg/dL)2, and cinacalcet use before kidney transplantation are strong predictors of persistent hyperparathyroidism. High-risk patients should be evaluated for parathyroid enlargement, and parathyroidectomy must be considered before kidney transplantation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Riñón / Hiperparatiroidismo Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Transplant Proc Año: 2017 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Riñón / Hiperparatiroidismo Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Transplant Proc Año: 2017 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos