Association Between Treatment of Secondary Hyperparathyroidism and Posttransplant Outcomes

Mathur, Aarti; Sutton, Whitney; Ahn, JiYoon B.; Prescott, Jason D.; Zeiger, Martha A.; Segev, Dorry L.; McAdams-DeMarco, Mara

doi:10.1097/tp.0000000000003653

Cited by 21 publications

(20 citation statements)

References 53 publications

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“… 115) 116) 117) In addition, secondary hyperparathyroidism continues in 40% of renal transplant recipients and persistent CKD-MBD is a significant determinant of progression of VC after transplantation. 118) 119) 120) The current data support that all types of VC (intimal and medial) is gradually deteriorated after renal transplantation.…”

Section: Clinical Implication Of Vascular Calcification In Chronic Kidney Diseasesupporting

confidence: 74%

Vascular Calcification in Chronic Kidney Disease: Distinct Features of Pathogenesis and Clinical Implication

Kim

Hwang

2021

Korean Circ J

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Author's summary Vascular calcification (VC) is highly prevalent in patients with chronic kidney disease (CKD) and leads to increased cardiovascular morbidity and mortality. In patients with CKD, traditional factors do not fully explain the high prevalence of VC. This suggests that a CKD-specific pathobiology is involved in the development of VC and mounting evidence indicates that VC in CKD patients has distinct features of clinical presentation and that clinical implications are changed compared to those in the general population. In this review, we discuss the mechanism, diagnostic imaging modalities, clinical features and implications, and management of VC in patients with CKD.

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Section: Clinical Implication Of Vascular Calcification In Chronic Kidney Diseasesupporting

confidence: 74%

Vascular Calcification in Chronic Kidney Disease: Distinct Features of Pathogenesis and Clinical Implication

Kim

Hwang

2021

Korean Circ J

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“…This approach was largely followed in our center. Interestingly, Mathur et al did not observe an association between treatment of sHPT and posttransplant delayed graft function, graft failure, or death, but the proportion of PTX-treated patients in their cohort of 5094 KTx recipients was small (4.5%) [24]. However, our data do not show a significant difference in eGFR courses between patients with and without PTX (Table 3).…”

Section: Discussioncontrasting

confidence: 62%

The Influence of Parathyroidectomy on Osteoporotic Fractures in Kidney Transplant Recipients: Results from a Retrospective Single-Center Trial

Jehn

Kortenhorn

Schütte‐Nütgen

et al. 2022

JCM

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Kidney transplant (KTx) recipients are a high-risk population for osteoporotic fractures. We herein aim to identify the role of pre-transplant parathyroidectomy (PTX) and other modifiable factors associated with osteoporotic fractures in KTx recipients. We conducted a retrospective study involving 711 adult patients (4608 patient-years) who were transplanted at our center between January 2007 and June 2015. Clinical data were extracted from patients’ electronic medical records. Different laboratory and clinical parameters for mineral bone disease (MBD) and osteoporosis, including medication, were evaluated. We chose fracture events unrelated to malignancies or adequate trauma as the primary endpoint. Osteoporotic fractures occurred in 47 (6.6%) patients (median 36.7 months, IQR 45.9) after KTx (fracture incidence of 10 per 1000 person-years). Prior to KTx, subtotal PTX was performed in 116 patients (16.3%, median time 4.2 years before KTx, IQR 5.0). Of the patients with fracture (n = 47), only one (2.2%) patient had previously undergone PTX. After adjusting for the known fracture risk factors MBD and osteoporosis, PTX remained a protective factor against fractures (HR 0.134, CI 0.018–0.991, p = 0.049). We observed a reduced risk for pathological fractures in KTx patients who underwent PTX, independent from elevated parathyroid hormone at the time of KTx or afterwards.

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“…This approach was largely followed in our center. Interestingly, Mathur et al did not observe an association between treatment of sHPT and posttransplant delayed graft function, graft failure or death, but the proportion of PTX-treated patients in their cohort of 5094 KTx recipients was small (4.5%) [23]. However, our data do not show a signi cant difference in eGFR courses between patients with and without PTX (Table 3).…”

Section: Discussioncontrasting

confidence: 60%

Parathyroidectomy Protects Against Pathologic Fractures After Kidney Transplantation: Results From a Retrospective Single-center Trial

Jehn¹,

Kortenhorn²,

Schütte‐Nütgen³

et al. 2021

Preprint

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Kidney transplant (KTx) recipients are a high-risk population for pathologic fractures. We herein aim to identify modifiable factors associated with pathological fractures and bone disease in KTx recipients. We conducted a retrospective study involving 711 adult patients (4608 patient-years) who were transplanted at our center between January 2007 and June 2015. Clinical data was extracted from patients’ electronic medical records. Different laboratory and clinical parameters for mineral bone disease (MBD) and osteoporosis including medication were evaluated. We chose fracture events unrelated to malignancies or adequate trauma as the primary endpoint. Pathologic fractures occurred in 47 (6.6%) patients (median 36.7 months, IQR 45.9) after KTx, fracture incidence of 10 per 1000 person-years). Prior to KTx, (subtotal) parathyroidectomy (PTX) was performed in 116 patients (16.3%) (median time 4.2 years before KTx, IQR 5.0). Of the patients with fracture (n= 47), only one (2.2%) patient was parathyroidectomized. After adjusting for known fracture risk factors for MBD and osteoporosis, PTX remained a protective factor against fractures (HR 0.134, CI 0.018 – 0.991, p=0.049). We observe a reduced risk for pathological fractures in parathyroidectomized KTx patients independent from elevated parathyroid hormone at the time of KTx or afterwards.

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Association Between Treatment of Secondary Hyperparathyroidism and Posttransplant Outcomes

Cited by 21 publications

References 53 publications

Vascular Calcification in Chronic Kidney Disease: Distinct Features of Pathogenesis and Clinical Implication

Vascular Calcification in Chronic Kidney Disease: Distinct Features of Pathogenesis and Clinical Implication

The Influence of Parathyroidectomy on Osteoporotic Fractures in Kidney Transplant Recipients: Results from a Retrospective Single-Center Trial

Parathyroidectomy Protects Against Pathologic Fractures After Kidney Transplantation: Results From a Retrospective Single-center Trial

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