Autonomy of Parathyroid Function After Renal Homotransplantation

Mcintosh, Duncan A.; Peterson, Emil W.; McPhaul, John J.

doi:10.7326/0003-4819-65-5-900

Cited by 98 publications

(20 citation statements)

References 14 publications

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“…However, recent reports have suggested that the hyperparathyroid state (as evidenced by hypercalcemia and hypophosphatemia) may persist following successful renal transplanta tion [4][5][6][7][8]. The hypercalcemia has been attributed to 'autonomy' of the para thyroid glands as well as to the use of antacids which act as phosphate binders administered after kidney transplantation [7,8]. Some patients with hyper calcemia have been managed successfully by phosphate supplementation [8], although isolated individuals have required subtotal parathyroidectomy in the early post-transplant period [8,9].…”

Section: Introductionmentioning

confidence: 99%

Secondary Hyperparathyroidism in Human Kidney Transplant Recipients

Pletka¹,

Strom²,

Hampers³

et al. 1976

Nephron

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76 kidney transplant recipients who were up to 4 years post transplant, were studied to assess the incidence of secondary hyperparathyroidism. All patients had good renal function with a mean serum creatinine of 1.4 mg/100 ml. Secondary hyperparathyroidism, as evidenced by increased serum parathyroid hormone levels, was present in 53 of the 76 patients (66%) and radiologic bone disease in 26 of the 76 patients (34%), while hypercalcemia (serum calcium greater than 11.0 mg/100 ml) occurred in only 6 patients (8.5%). The incidence of secondary hyperparathyroidism decreased slightly with time following transplantation, but the degree of secondary hyperparathyroidism as indicated by the levels of serum parathyroid hormone at various times following renal transplantation was essentially similar. The causes for the persistence of this condition are not totally known, but it was found that its incidence was related to the duration of dialysis prior to transplantation.

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Section: Introductionmentioning

confidence: 99%

Secondary Hyperparathyroidism in Human Kidney Transplant Recipients

Pletka¹,

Strom²,

Hampers³

et al. 1976

Nephron

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“…the pretransplant period so that the tendency for further soft tissue calcifi cation should certainly have decreased. However, hyper- [34], pre sumably was present in all of them, and could have resulted in a further rise in serum calcium. Despite this, the calcium-phosphorus product which is frequently high in uremic patients with clinically significant secondary hyperparathyroidism, and which is generally thought to be the major cause of soft tissue calcification, should have decreased.…”

Section: Discussionmentioning

confidence: 99%

Systemic Calciphylaxis Revisited

Adrogué¹,

Frazier

Zeluff³

et al. 1981

Am J Nephrol

103

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A syndrome characterized by rapidly progressive ischemic necrosis involving large areas of the skin and muscle, and by peripheral gangrene associated with extensive vascular calcifications was observed in a patient with end-stage renal failure on chronic hemodialysis. In an effort to control the disease, parathyroidectomy was performed which resulted in rapid improvement of tissue perfusion. However, the patient eventually died from sepsis within 2 months after admission. This case presents the typical features of the syndrome of systemic calciphylaxis. The literature is reviewed searching for similar cases of this poorly recognized, but life-threatening, clinical syndrome. The pathogenesis, clinical manifestations, and therapy of this unusual and rapidly progressive, but potentially reversible, condition are reviewed with emphasis on its prompt recognition and appropriate management.

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“…Patients with chronic renal failure usually have second ary hyperparathyroidism, and their serum parathyroid hormone levels often are markedly elevated [22]. More over, those individuals who have undergone a renal transplantation frequently still have elevated levels of parathyroid hormone [23], Hence, if hyperparathyroid ism increases the risk of malignancy, one would expect to find a high incidence of malignancy in patients with chronic uremia or in kidney transplant recipients. Such an association has been observed by a number of inves tigators for nondialyzed patients with chronic renal fail ure.…”

Section: Observed Association Between Hyperparathyroidism and Neoplasmentioning

confidence: 99%