Persistent hyperparathyroidism after preemptive kidney transplantation

被引：5

作者：

Okada, Manabu ^{[1
]}

Sato, Tetsuhiko ^{[2
]}

Hasegawa, Yuki ^{[1
]}

Futamura, Kenta ^{[1
]}

Hiramitsu, Takahisa ^{[1
]}

Ichimori, Toshihiro ^{[1
]}

Goto, Norihiko ^{[1
]}

Narumi, Shunji ^{[1
]}

Takeda, Asami ^{[3
]}

Watarai, Yoshihiko ^{[1
]}

机构：

[1] Nagoya Daini Hosp, Dept Transplant Surg & Transplant Nephrol, Japanese Red Cross Aichi Med Ctr, 2-9 Myoken Cho,Showa Ku, Nagoya, Aichi 4668650, Japan

[2] Nagoya Daini Hosp, Dept Diabet & Endocrinol, Japanese Red Cross Aichi Med Ctr, Showa Ku, Nagoya, Aichi, Japan

[3] Nagoya Daini Hosp, Dept Nephrol, Japanese Red Cross Aichi Med Ctr, Showa Ku, Nagoya, Aichi, Japan

来源：

CLINICAL AND EXPERIMENTAL NEPHROLOGY | 2023年 / 27卷 / 10期

关键词：

Hyperparathyroidism; Multivariate analysis; Preemptive kidney transplantation; GLOMERULAR-FILTRATION-RATE; SURFACE AREA RATIO; SECONDARY HYPERPARATHYROIDISM; TERTIARY HYPERPARATHYROIDISM; RISK; ASSOCIATION; MORTALITY; PREVALENCE;

D O I：

10.1007/s10157-023-02371-9

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundLong-term dialysis vintage is a predictor of persistent hyperparathyroidism (HPT) after kidney transplantation (KTx). Recently, preemptive kidney transplantation (PKT) has increased. However, the incidence, predictors, and clinical implications of HPT after PKT are unclear. Here, we aimed to elucidate these considerations.MethodsIn this retrospective cohort study, we enrolled patients who underwent PKT between 2000 and 2016. Those who lost their graft within 1 year posttransplant were excluded. HPT was defined as an intact parathyroid hormone (PTH) level exceeding 80 pg/mL or hypercalcemia unexplained by causes other than HPT. Patients were divided into two groups based on the presence of HPT 1 year after PKT. The primary outcome was the predictors of HPT after PKT, and the secondary outcome was graft survival.ResultsAmong the 340 consecutive patients who underwent PKT, 188 did not have HPT (HPT-free group) and 152 had HPT (HPT group). Multivariate logistic regression analysis revealed that pretransplant PTH level (P < 0.001; odds ratio [OR], 5.480; 95% confidence interval [CI], 2.070-14.50) and preoperative donor-estimated glomerular filtration rate (P = 0.033; OR, 0.978; 95% CI, 0.957-0.998) were independent predictors of HPT after PKT. Death-censored graft survival was significantly lower in the HPT group than that in the HPT-free group (90.4% vs. 96.4% at 10 years, P = 0.009).ConclusionsPretransplant PTH levels and donor kidney function were independent predictors of HPT after PKT. In addition, HPT was associated with worse graft outcomes even after PKT.

引用

页码：882 / 889

页数：8

共 30 条

[1] Normocalcemic versus Hypercalcemic Primary Hyperparathyroidism: More Stone than Bone? [J].